ALS vs PLS

[AnilKumar]

Anybody have experience with bulbar onset motor neuron disease in 90s and still able to walk?
Timeline of events for my 94 year old mother:
May 2021 - Complains about slight shortness of breath to primary care.
January 2024 - Starts coughing due to aspiration when eating.
February 2024 - Begins intermittent slurred speech.
August 2024 - Speech very difficult to understand. Only about 50% of words recognizable. Weight 105.
Dec 2024 - Unable to speak.
March 2025 - Weight 87. Still able to eat a little. Walks with cane. Still performs all self-care.

Is this rapid progression of ALS or slow progression of PLS?
I have asked her doctors but even the ALS doctors have little experience with this situation.

 

[Nikki J]

If her 2021 symptoms are part of it it isn’t rapid als. Even from 2024 January rapid als wouldn’t be walking.

At 94 it seems possible the walking issue is separate? If it is it could be pseudobulbar palsy or isolated bulbar als.

Whether this is all upper motor neuron ( pls) or als which is upper and lower would be determined by her clinical exam and her tests. You can’t tell by progression rate Slow progression als exists