Could this be the Bulbar ALS?

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New member
Mar 8, 2024
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Hey! I’m a male 28, soon to be 29.

9 days ago my speech started to slurre, and it still does. (But it seems I’m the only one noticing it so far). It's hard to articulate many different words at one time but eventually after trying in 10 minutes to say it again I tend to succeed.
It feels like my tounge, cheek and mouth are not coordinating and are not working properly, like it's getting weaker and I have like weird sensation on my tip of the tounge like I have burned myself and I'm going to lisp because of that. I also get tired in the tounge by talking. I start to have a harder time talking more fluent and I’m stuttering on words and slurre on other words etc.

I also have fasiculations on tounge, I can see them but I don’t feel them. I do have fasiculations randomly over the whole body as well, but those I feel. I do have a clean EMG that is 7 days old. But I’m scared of bulbar onset because I also heard a lot of people with bulbar onset have a clean emg and it have not shown anything because it is to early in the progression. And also because since I did the EMG, the speech have been progressing to the worse, that is why I am worrying.

What do you think?

I would also say that it feels in the mouth,cheeck,teeth,tounge (not all the time) like I have been at the dentist and had lidocaine which has started to wear off.
If no one else is noticing speech changes, they are not worth worrying about.

ALS does not present as suddenly as you describe, bulbar or not. I would discuss dry mouth, allergies, and sleep patterns with your PCP. You can also track your sleep with a wearable and see how your stages of sleep compare with others'.

I have some questions about bulbar onset ALS.

1.If you truly had slurred speech (even in the very beggining) because of bulbar onset ALS, would you be able to move your tounge freely from side to side and outside/inside and up and down, around and also whistle? Or is the slurred speech made because of limited muscle movement of the tounge, which means that this would appear obvoius for the neurologist during a clinical eximination? Or could it be so very early in the beginning of the onset so the movement of the tounge is still normal?

2. Also, is slurring constant with bulbar or in the very beginning does it come and go?

3. What are early other signs of bulbar onset? Like was there tightness/pain/did the tounge feel off/too big or other things you noticed in advance? (just trying to see where my situation fits in)

Thank you for your time! I hope I can get some answers to clear my mind.

Kind regards,
Without getting too deep into the weeds, speech difficulties are really only meaningful (while still not specific to ALS) if they are ongoing, noticed by others without prompting, and represent a clear change that fatigue and anxiety can't explain. Pain and strange feelings really aren't part of ALS onset.

If a neurologist said that you don't have bulbar impairment, I'd believe them. If that hasn't happened, the first step is a PCP visit and then if warranted, a visit to whatever kind of professional is recommended given your exam and any tests.
From yesterday I have started to bite my tounge several times while speaking, and my tounge touches the teeth all the time while I’m speaking, and it’s very painful. So I guess I really do have bulbar Als. I don’t come up with any other explanation, what do you think?
I think you are leaping to unwarranted conclusions fueled by mr google and anxiety. Please go back and talk to your doctor. We can’t keep holding your hand
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