Onset of symptoms may occur as early as age 35. Generally, however, most people are diagnosed in their 50s or 60s. The typical APBD patient will begin with numbness in his or her extremities, often in the toes and feet. In addition, he or she may often develop urinary frequency that far exceeds the norm. Over a period of years the numbness will progress to a loss of muscle control, and eventually to an inability to walk. The urinary frequency will often progress to a near complete loss of urinary control.

The numbness and urinary problems are by no means all of the bodily systems affected by APBD. Damage to other parts of the body varies from person to person. The last few years of life follow a similar pattern to other debilitating degenerative diseases like ALS and MS.  It has been documented that APBD patients have a reduced life expectancy.