Bulbar ALS?

[abc1234567]

Hello, everyone,

I've been having a lot of anxiety about some of my symptoms and was looking to see if anyone could provide clarity.

I have to do a lot of technical, fine work with my hands through my occupation and began noticing that things just didn't feel quite right a couple of months ago. From there, I started noticing a "tight" feeling in my forearms. This probably started about 2 weeks ago. Initially, I didn't think anything of this. However, as I started to become more and more worried, I began realizing that I am experiencing twitches all over my body. They're especially noticeable in my hands but I feel them everywhere. Legs, calves, thighs, back, feet, etc. My fingers will even "jump" from time to time. I've really noticed trouble typing on a keyboard over the last week. I seem to type somewhat slower than I used to and will even strike the wrong key on accident from time to time. My hands also seem to cramp up with prolonged use/contraction, but I wouldn't say that weakness is a problem. It's more that things just don't seem to work as well as they used to/coordination is off. I'll be the first to admit that this problem seems to be worse when I am feeling more anxious or thinking about it.

I haven't noticed weakness anywhere else in my body. Everywhere else that I feel twitches seems to be just as strong as it has been. To be fair, I really don't know how long the twitches have been going on. I know that anxiety is something I suffer from and wonder if, when my anxiety is heightened, the twitches aren't worse.

So where do the bulbar symptoms come into play? I started thinking/paying more attention to everything and have realized that, for at least the last 2 months, I will occasionally cough while drinking liquids. This usually happens with water but any thin liquids can cause it. Again, it is not all of the time. I wouldn't even say that I always aspirate; sometimes it's more a feeling that I have to cough once I'm done taking a few big gulps. There are other times I can suppress it. Also, for about 1 week, I've felt as though I'm talking funny or taking more pauses while speaking for long periods of time. My wife says she hasn't noticed me slurring or anything and, to her ear, my speech is normal. Again, I've been highly anxious and reading more and more to find out what could be going on. I did recently try a new SSRI for about 2 days and this seems to correspond to the first time that I noticed my tongue felt odd. The swallowing "issues" had begun far before this. As I mentioned, I stopped the medication after 2 days because I did not like the way that it was making me feel, but the issues with feeling my tongue/mouth were odd has persisted.

Does any of this sound concerning? Is it all in my head?

Thanks

 

[lgelb]

No, none of this sounds concerning for ALS. You have no loss of function, issues that are exacerbated by introspecting them, and no changes noticed by others. Many people are finding themselves more "inside their head" with Covid everywhere.

There are a ton of free exercise streams out there and I would try one, specifically for classical stretch. If you are on a new SSRI now, hopefully it will help address your anxiety as well. Forearm tightness can relate to keyboard use and positioning in your chair, so wouldn't hurt to reassess those from an ergonomic perspective. Finally, have a "go-to" fun activity, like walking or listening to music, when you start to worry.

Stop reading, start living.

Best,
Laurie

 

[abc1234567]

Thanks for the reply. The biggest concern that I have had revolves around the bulbar type symptoms. In addition to what I've mentioned, I also feel as though my lips/mouth and even tongue have been twitching more and more lately. I notice this at rest, when I speak and possibly even when I eat. Again, I've had no difficulty eating or speaking; I feel as though there are things that I say/pronounce somewhat funny but no one else has noticed an issue. To reiterate, I know that anxiety is a big part of everything for me, I just don't really know what true tongue fasciculations feel like (if anything). Thanks again.

 

[Nikki J]

Twitches including tongue and face without loss of function mean nothing. please read or reread the important post at the top of this subforum you will see a section that addresses tongue twitches