Hi ! Welcome to the forum but so sorry about your need to join. How old is your brother? My dad just turned 80. He got his diagnosis of ALS two years ago in May. He has limb onset. He started with the foot drop and then had several horrible falls in which his legs just gave out. Nobody can really give you a answer on how things will progress. We see all different ranges on here. Could you brother get into a clinical trial by chance? Have family take every precaution to prevent a fall. He and other family members should also get a flu shot. Is he a veteran by chance? Take care, Kim (SKipper)