I have had fasciculations for about three years but lately have been getting them more in my face and tongue. I also began choking on liquids at least once a day about two weeks ago. I went to my internist who said we need to rule out ALS. I am beyond terrified as I have three young children. Can anyone with Bulbar ALS tell me what your initial symptoms were? Can it start with swallowing or is it usually speech. My speech is okay for now. Thanks in advance for your support.