My husband sounded really nasally for a long time before the slurring occurred. He thought that his allergies were acting up. He also sweated more than usual. He also had mild twitching for years. Of course we realize this all now in retrospect. Oh...he also had major alcohol intolerance..after one drink..his speech would go way downhill.
with hindsight, I had cramps in my legs every morning when I woke up and stretched, and I was constantly yawning...huge uncontrollable yawns at most inappropriate times. This was going on for at least a year. Then as you say my tongue felt VERY odd and increased saliva. Add to that, which other people noticed, my speech slowed down and I was constantly swallowing and interupting my speech added to the slurring. My GP and neuro both said within minutes of seeing me that I had bulbar issues. within a few weeks it was confirmed.
Yes I had leg cramps (NO twitching)... a speech therapist (referred to due to voice changes) said I sounded nasal, and I remember feeling offended that she said that, because I'd always had a pleasant voice, and equated nasal with anything but! However it turns out it was nasal, due to soft palate weakness. I've never had excess saliva. I actually did sweat for a few months more than normal, but figured I was hormonal LOL)
my mom complained of leg cramps and feeling old, she used to yawn a lot too. A stupid doc said its depression/boredom. Then the slurring started, we met close to 5 ent MDs, they all said she was fine, till we met a neuro..it was all downhill from there.
My wife had a bit of slurring and we thought it might be a mild stroke. The doctors couldn't find anything. She noticed that her tongue was fesiculating. We went to a neurologist and he noticed that her tongue was also slightly indented along the sides on the bottom. But he didn't think it was PBP - "benign fesiculations" he said. But he was wrong and the slurring got worse. We thought it might be myasthenia gravis or brain parasites or God knows what. No doctor could figure it out until we went to Mayo Clinic in Scottsdale and Dr. Bosch diagnosed it immediately. Sadly the slurring has continued along with the rest of PBP symptoms
My dad also had leg cramps and excessive yawning before the slurring began. He also had what appeared to be mood swings. He sometimes got very inappropriately snappy. Of course we only realized these were symptoms in hindsight.
The first thing that I noticed was drooling last Fall-not excessive but noticeable. In December, I noticed that his speech sounded like he had been drinking at times and he started complaining of a stuffy, plugged up nose. Then it was frequent clearing of his throat, coughing and choking and c/o thick sticky oral secretions and incredible fasiculations of his tongue when I looked in his mouth. This was with his tongue at rest in his mouth. In hindsight, he had excessive yawning for a year prior to that-horrible charlie horses in his legs at night and frequent c/o of headaches when he would awake in the morning. Interesting to me that other people on the forum have noticed a change in their PALS personality-my Husband also had uncharacteristic "snappiness" that started last fall. That has improved dramatically with the Paxil!
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.
Beth the parallels between yours and my dad's symptoms are incredible. He had the yawning bouts, the red face, the snappish inappropriate behavior. He also had a coughing spell in 2006 that made him so dizzy he passed out momentarily. Everything went downhill for my dad after his angiogram too and that's when his slurred speech began. It's crazy how similar your histories are!
My dad's first symptons that we noticed was slurring of speach. Along with that came choking on foods that were especially spicy. We really did think that he had had a mini-stroke. He became very concerned and started to notice things when his golf score increased 20 strokes from one year to the next and it took him two hands to hammer in a nail.
I started with shortness of breath when speaking followed by a raspy voice. After a few months the nasal escape, stuffy nose and slurring speech began. I had the feeling that my tongue was to big for my mouth. I was being treated for allergies, a deviated septum, tyroid and acid reflux. It took 9 months and 13 doctors with mega testing before I had an emg and was diagnosed with als.