Dysphagia, speech slurring, muscle twitching - tongue EMG?

[annehermann]

Hello,
Thanks to all who take time on this site. I am wondering if what I really need is a tongue EMG?

I am a 49-year-old who has children, works full time and exercises regularly. My symptoms are as follows:

3 years ago developed fasciculations in all muscles without weakness (from eyelids and mouth to back, arms, and legs). I did not seek medical attention for this as no weakness until 8 months ago

8 months ago, started to slur the letters "r", "L", "S" and "sh"

3 months ago dysphagia and more pronounced twitching in my upper lip and eyelid. A modified barium swallow showed mild dysphagia

1 month ago diagnosed with hypoglossal nerve weakness by neurologist in conjunction with speech therapist. He also noted hyperreflexia (which I think is generalized thank goodness) and fasciculations on exam.

Studies that are negative are lab work, MRI, PET scan (to rule out base of tongue tumor) and EMG of limbs.

At this point, we are planning to conduct a second modified barium swallow to see if dysphagia is progressing. I am wondering if I should push for a tongue EMG since all my symptoms have to do with speech and swallow?

Again, thank you for your time.

 

[affected]

You need to ask your neurologist what they feel is needed.
You are not qualified to begin to tell them how to conduct tests. ALS would not be diagnosed by a tongue EMG since all other areas have tested clean. ALS is a widespread disease and would show even in areas you haven't noticed yet.
If you don't believe your doctor go get a second opinion without telling the next doctor what you believe is going on. There are other more common causes for your symptoms than ALS - ask you doctor to talk you through what they think after the second MBS.
However, it sounds like your current doctor is following a logical diagnostic path. I know it is frustrating to have to wait for answers. I wish you the best, but honestly, your doctors are the ones to figure this out, not you.

 

[annehermann]

Hello,
Thank you for the reply.