My initial ALS symptoms started in my tongue (also known as Bulbar onset). They started beginning 2011(January, to be exact). And they started with tongue weakness, later tongue fasciculations showed up, and finally tongue atrophy (yeah, my tongue shrunk half its size).
My ALS diagnosis was done in Dec. 2011 (exactly 11 months after the first symptoms began.
Every ALS patient is different and, in others, ALS may start in the hands or in the feet.
It's a disease more complicated than you might think.