In 20-20 hindsight, I now believe that I had ALS symptoms going back to the mid-1980s, when I began experiencing intense yawning bouts ... REALLY bad and uncontrollable, and very embarrasing. In the early 1990s, I began experiencing a red face with no cause. Lobster red. Always, my b/p was OK, pulse was OK, heart, etc. I never connected this with ALS until this last week, when I read on the forum that others have had it, too. In the late 1990s, I began experiencing "snappish" and inappropriate behavior. (I shoved a co-worker, for one thing, during a loud argument about politics in the middle of the office.)
In 2002, I became suddenly very dizzy and short of breath. This lasted for some weeks, fading away. No cause was ever found. I was eventually sent to a neuro, but he couldn't find a cause. The same thing happened again in December, 2005, when my legs gave out on a treadmill at the gym and I couldn't breathe.
It was in checking me out for the last problem in the hospital with a routine angiogram in March 2006 that the doctor poked a hole in an artery and they rushed me to emergency open heart surgery. I woke up from that with slurred speech (and blurred vision) and it's been downhill all the way ever since.
Any or all of those could have been early signs ... I never had any idea. But my first BULBAR sign was slurred speech.