Plucky81
New member
- Joined
- Jun 18, 2017
- Messages
- 3
- Reason
- Learn about ALS
- Country
- AUS
- State
- Nsw
- City
- Syd
Hi All,
Seeking some guidance here, thanks in advance for your replies.
I am a 35y old male, Starting in October 2016 I initially had numbness and tingling in my right arm leading to an NCS/EMG, NCS was normal EMG showed chronic partial denervation in a C7 distribution consistent with a chronic radiculopathy. Numbness and tingling resolved but was replaced with symptoms of mild speech issues which no one else noticed consisting of a slight slur and general feeling of more effortful speech. In late January 2017 I went to my regular physician, who is extremely capable and thorough, with my concerns. He referred me and I had a second EMG at a clinic experienced in Neuromuscular disease along with a very thorough clinical exam. EMG was of both arms and left leg, many insertions and very thorough. EMG results were normal told no ALS. Clinical exam normal apart from assymetric triceps reflex, less in left arm told no ALS. Told EMG Neuro and Neuro who did clinical about speech concerns both seemed unconcerned and told me no ALS, dont need to see me again. Also I have had a ENT evaluate my mouth and tongue and a full head/spinal MRI both of which were unremarkable.
Since this time I have continued to have mild speech issues, only I notice and some mild swallowing issues. I think speech has gotten slightly worse over 6 months but its assessment is complicated by the long time frame, certainly has not improved. My most concerning issue is my tongue which is very assymetrical and very scalloped and looks altogether messed up, this has gotten worse over the 6 months. I do not see obvious tongue fasciculations.
My questions are:
1.How unusual would a clean clinical and clean limb EMG be in early Bulbar ALS?
2.Taking into account my young age (ALS wise), is minimal change over 6 months for Bulbar very unusual?
3.Can tongue atrophy ever occur without obvious fasciculations at rest?
4. Can tongue atrophy occur without gross deterioration in speech and tongue mobility?
Thanks in advance for any replies, I am very concerned about these symptoms and their insidious development. I have read widely to find out as much as I can but am reaching out in the hope that someone might be able to shed some light on the above.
Seeking some guidance here, thanks in advance for your replies.
I am a 35y old male, Starting in October 2016 I initially had numbness and tingling in my right arm leading to an NCS/EMG, NCS was normal EMG showed chronic partial denervation in a C7 distribution consistent with a chronic radiculopathy. Numbness and tingling resolved but was replaced with symptoms of mild speech issues which no one else noticed consisting of a slight slur and general feeling of more effortful speech. In late January 2017 I went to my regular physician, who is extremely capable and thorough, with my concerns. He referred me and I had a second EMG at a clinic experienced in Neuromuscular disease along with a very thorough clinical exam. EMG was of both arms and left leg, many insertions and very thorough. EMG results were normal told no ALS. Clinical exam normal apart from assymetric triceps reflex, less in left arm told no ALS. Told EMG Neuro and Neuro who did clinical about speech concerns both seemed unconcerned and told me no ALS, dont need to see me again. Also I have had a ENT evaluate my mouth and tongue and a full head/spinal MRI both of which were unremarkable.
Since this time I have continued to have mild speech issues, only I notice and some mild swallowing issues. I think speech has gotten slightly worse over 6 months but its assessment is complicated by the long time frame, certainly has not improved. My most concerning issue is my tongue which is very assymetrical and very scalloped and looks altogether messed up, this has gotten worse over the 6 months. I do not see obvious tongue fasciculations.
My questions are:
1.How unusual would a clean clinical and clean limb EMG be in early Bulbar ALS?
2.Taking into account my young age (ALS wise), is minimal change over 6 months for Bulbar very unusual?
3.Can tongue atrophy ever occur without obvious fasciculations at rest?
4. Can tongue atrophy occur without gross deterioration in speech and tongue mobility?
Thanks in advance for any replies, I am very concerned about these symptoms and their insidious development. I have read widely to find out as much as I can but am reaching out in the hope that someone might be able to shed some light on the above.