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Lark2

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Learn about ALS
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US
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NY
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holbrook
anybody ever hear about bulbar symptoms starting with lip problems as onset,,,ie atrophy,Lips sticking together,lip twitching,mispronunciation of words.... without swallowing difficulties?
 
You don't get ALS atrophy without weakness first. Atrophy is the result of muscle weakness, it doesn't cause muscle weakness.

I'm sure there could be weakness in any of the bulbar areas at onset ... tongue, lips, cheeks, throat. But if your lips were weak, your speech would show it by slurring ... not by "mispronouncing words." Signs of weakness in lips would be the inability to pucker or pronounce certain consonants, inability to close your lips, etc.

The usual first sign of bulbar onset is slurred speech, caused by weakness in the tongue, cheeks and lips, followed later by swallowing problems, but some people do have swallowing problems first.

But, as has been said many times on this forum, ALS is about muscle weakness. Without actual weakness, it's not ALS.
 
the way I noticed lip atrophy was I kept biting my lower lip, and insides of my cheeks. Then, after a while, a doctor asked me if I could whistle, and I said "sure!" but when I tried to demonstrate, I no longer could, because I could not pucker my lips into a tiny enough circle. (once again making me wish I'd learned to "teeth whistle" like guys do. )

EMG performed on the lips and face is done with very fine needles, and does not hurt at all fyi...
 
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