Does the development of bulbar symptoms ever present this way?

[MrD1]

I started having balance problems and fasciculations in 2018. I had an EMG done that showed increased insertional activity and fascics in proximal and distal muscles. I was later diagnosed with CMT in 2022 by a physician who only performed the EMG on distal musculature and was not concerned with proximal muscles. I was okay with my CMT diagnosis and accepted it. In 2020, I lost several ranges in my voice (I like to sing and couldn’t hit notes I’d been able to before). This seemed to improve somewhat - or I compensated and stopped noticing over time.

However, a month ago I noticed a sharp pain under my Adam’s apple when I would yawn. This persisted for about a week. After it went away, I noticed I am having a lot more difficulty speaking. I can’t project as well and my normal speech has changed as higher pitches (still that you would use during normal speech) are basically gone. My voice sounds like I’m really struggling and going through puberty again.

I guess my question is this - has anyone ever heard of onset of bulbar symptoms that were just related to your ability to speak and project loudly and at different pitches? I do not have any issues with my tongue or facial muscles, but have had twitches in my throat and face.

I’ve attached that old EMG from 2019.

Thank you.

 

[ShiftKicker]

Hi there-

I'm wondering if you've seen a doctor about your voice changes yet. There are many reasons for hoarseness and an examination would go a long way towards sorting out what it might be- thyroid, hormonal, infection, etc.

 

[lgelb]

Agree, see an ENT. A 5y-old EMG isn't revealing and this does not sound like ALS.

 

[KAD]

Hi - I’m a speech pathologist, and agree that you’ll want to see an ENT to have your larynx (“voice box”) evaluated. They’ll be able visualize your vocal folds and that will be the best route for determining what’s happening. It’s highly unlikely that voice changes you describe are ALS related (not in keeping with upper or lower motor signs). Best of luck!