Could this be ALS?

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taylormarie103

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Hi,
I have read the post so realize some things don’t add up but am slightly concerned. I’ve already had an MRI that was clear but have had fasciculations around mouth area and what feels like an internal tremor in upper body for about the last two weeks as well as feeling as if my lower lip is trembling. The neuro did an in office neuro exam and didn’t seem concerned about strength or anything but didn’t really check my mouth or anything.

I feel as if the last week I’ve had difficulty swallowing. I have never choked at any point, just feel as if some things have difficulty going down. I also feel like I’m creating a lot of saliva while talking and keep getting nervous that I’ll soon start slurring words. I do feel as if I have to constantly swallow hard and clear my throat to feel like nothing is there.

Should I be concerned about bulbar with the fasciculations, what feels like my lip trembling at times, and now the odd swallowing feeling? I may just be paranoid as I do often let my anxiety get to me but it’s just been weird things ongoing and I’m only 32 so very concerned.

Thanks in advance, and praying I’m not offending anyone by asking such.
 
Hi, just wondering if anyone could give me any feedback as I am quite worried.
 
Hi sorry you did not get answered.
twitches and tremors don’t sound concerning. A normal neuro exam is very reassuring and I guarantee they were assessing your lip / mouth/ facial movements and speech during the visit

feeling trouble swallowing but nor actually having trouble swallowing? Doesn’t sound like bulbar to me but please make an appointment with your gp to review your concerns
 
I would return to your PCP and have a general check up and see what should be investigated, but I wouldn't think ALS should even be mentioned. Sorry your post go missed it did not even show up for me until now.
 
Thanks everyone for your replies. Hard not to let your mind run wild when you start having new and odd symptoms. My husband is a Physical Therapist so I have been making him do strength tests and check my reflexes so often he may soon divorce me. HA!

I unfortunately searched internal tremor and jaw quiver and had hits with others having it on here so down the rabbit hole I went even more. I do see that is often a BFS symptom as well so hoping that is all I am dealing with, along with some good old health anxiety.
I of course got a cold a couple of days ago so maybe what I perceived as throat/swallowing issues were that coming on... as I am still eating and drinking without choking or anything.

I guess my main concern was not knowing if anything else would have been noted on her general in office exam had I not been having the weird symptoms that I now am, at the time. (she did strength tests, checked some reflexes, had me walk, etc)
Also, if bulbar, would it be common to have such widespread fasciculations/twitch? (hands, thighs, arms, etc) and not notice any actual weakness?

I appreciate all of you that take your time and reply to people such as myself. Thank you
 
1 I searched internal tremor too pages of posts about it- from people who didn’t have ALS. All the way back in 2015 there was one PALS who admitted he was misdescribing it and actually had fasciculations.
2 jaw quiver. In ALS people have jaw clonus not quiver- like violently chattering teeth

yes people with bulbar can have limb twitches without weakness but you have not presented any convincing description of bulbar onset so that fact should be irrelevant to you

if you are still concerned please address your question to your doctor
 
I suggested your return to your PCP but instead you started searching the internet.
Please go see a doctor, we can't reassure you obviously as you are going to keep pushing by searching for more evidence.
You can get help if you discuss openly with the doctor examining you so they can answer in context of their findings.
 
I did schedule another appt and the searching was initially what prompted me to ask the questions. I understand your frustrations at so many who come on here asking questions that you constantly have to repeat answers to, so I apologize if that’s how I made you guys feel.
Praying the fasciculations, new cramps
I’m experiencing and feeling as if my lips are weak are nothing and I can move on from this constant worry soon.
I do have a background in healthcare as well, and sometimes when you’ve seen it all and know that nobody’s truly exempt from anything- it weighs on you and probably causes me more worry.

Thanks for everything.
Happy New Year to you all.
 
It isn't frustration at you, it is concern that you are seeking internet help instead of medical advice.
As someone who has a background in healthcare you probably also know that a little bit of internet knowledge is a dangerous thing and a deep rabbit hole.
All the very best, I'm sure those new things you are experiencing can get dealt with by a doctor, but they still don't raise any ALS red flags.
 
Let's hope it isn't anything serious. But if you do hear from a neurologist that ALS is a possibility, at that point I'd advise you to figure out how to live with the uncertainty, because an ALS diagnosis generally doesn't happen quickly.

You might want to look up Mehitabel the Cat. She was always a lady. When someone is undergoing evaluation for ALS, they either learn how to live with the uncertainty, or they go bananas. I hope you figure out what's going on soon, and that you feel better soon.

Your primary might be able to help with the anxiety. I went back on an SSRI to help me with the uncertainty and anxiety. Mainly, I just had to be patient (which doesn't come naturally to me).
 
I see no reason to think of anything serious, let alone ALS.

General note: 99.5% of the people who set foot in CIBALS (this subforum) don't have it. And a neurologist that says ALS is a "possibility" is always speaking literally unless it has been formally ruled out, often as a CYA move, not a serious diagnostic statement.

One reason we discourage the worried well from seeing (or revisiting) neurologists without going through their PCP is the shortage of neuromuscular specialty appointments, which can be a major factor in diagnostic delay. Inability to distinguish ALS from mimics and not-serious conditions is fairly rare these days and thus less often a reason for "delay."
 
I did see my primary today and he wasn’t overly concerned with anything. Checked my cranial nerves, looked at my tongue, checked some reflexes and nothing seemed hyper, made me do a few other things, etc.
Said he does want me to follow up with neurology but didn’t seem super concerned and told me he didn’t think I had ALS of any form so that helped ease my mind a bit. Did order a ton of labs because I only have part of my thyroid and a history of hormonal issues, plus I’m sure checked for some other things as well.
It’s been a rough few months with some family issues so praying it’s just stress rearing it’s head and nothing too wild.
 
I think that often when we stress that we don't see any ALS flags, people think we are saying there is nothing wrong.
That's kind of black and white.
Your doctor is following a very logical path based on your clinical examination and tests to date which is what should happen. That is great news.

Please let ALS go, block this site, stop googling and let the medical professionals figure all this out. Frustrating as it may be, you are not helping if you search and make suggestions on what you think is wrong. They will get to the bottom of this faster following their own unbiased evidence based methodology.
All the very best.
 
You are fine.
 
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