Early Bulbar Als?

Concernfarther1

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Hello- first i want to say i pray for everyone affected by this terrible disease. My reason here is to see if anyone has experience with what i have and if this is early signs of bulbar als.

For 3 months i been mumbling speech more than in the past. I feel my tongue is too big for my mouth. Back in Feb when this started i went to see a neurologist. He ordered Emg/ncv upper and lower, ssep upper and lower, mri of cervical spine and mri of the brain. My test showed carpal tunnel in the right hand, mild ulnar compression right elbow. Mri showed cervial severe stenosis and cervial spondylosis myelopathy.

I originally went to the doctor for dizziness, was diagnosis with vertigo in June 2021. Was also having same balance issues and pain in right leg. My speaking was real reason for visit. The balance and issues walking he said is my CSM diagnosis , he said he doesn’t hear anything with my speaking and said i don’t have bulbar als. He didn’t do the emg part bc on my ncv my motor was normal. He said i have bad anxiety which i do.

My question for everyone is does this sound like bulbar als? I know it effects speech, i don’t have any swallowing issues. Just when i speak more people say what do i have to repeat myself. It’s more mumbling than slurring . I’m 38 yr old male. Very nervous this is early bulbar since i read about it and a ton of people my age on boards said it started with only mumbling and no other symptoms, is it possible i did the test too early? Should i demand the emg need part of the emg to be done? Any help with be appreciated
 

ShiftKicker

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Hi, I've moved your thread to the correct subforum. If you could please read Read Before Posting first, it should answer many of your questions. You'll note things like vertigo and pain point away from ALS. It also addresses getting tested too soon.

If you do not find the information in the "Read Before" reassuring, and already receiving an explanation from your neurologist for your symptoms, what would reassure you? A return visit to your neuro to go over your questions may help, but demanding a test the neuro has assessed you do not need (EMG) may not assist in finding out what is wrong. Perhaps a better question to ask the neuro is "What might be causing my symptoms?" instead of focusing on a disease your symptoms do not indicate.
 

Concernfarther1

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Thank you. Yes i agree i asked him what is causing my speech. I notice it he said he didn’t. However he isn’t with me everyday to notice. My question still is would bulbar just be in my speech? Mumbling words and pronunciation isn’t that signs of dysarthria which is related to als? He ruled out MS based on all the test. And said in my report he’s ruling out als at this time. But can’t it take a year to diagnosis ? And maybe i went too early to test.
 

Clearwater AL

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Concern., your neurologist said....

"he said he doesn’t hear anything with my speaking and said i don’t have bulbar als.
He didn’t do the emg part bc on my ncv my motor was normal. He said i have bad anxiety
which i do.".

Key words... "and said i don’t have bulbar als."

Key words... . "He said i have bad anxiety."

I doubt anyone here will over rule a highly trained, highly educated, experienced
neurologist.

Finally...
"i read about it and a ton of people my age on boards said it started with only mumbling
and no other symptoms"

Thousands of people have falsely convinced themselves they have a
serious disease after turning to 'Dr. Google' – according to new research.
Instead of alleviating concerns, 74 percent of those who have self-diagnosed
online searching for their symptoms made them worry more about their health.

That is due to the answers given by Dr Google, of internet medical advice,
was found by researchers to be misleading without proper evaluation by a
a qualified physician. (Which you have.)

Sixty-five percent of respondents who used the internet to self-diagnose themselves…
the results show typing your symptoms into the search bar might do more harm than
good.

Hope you find peace of mind concerning your health worries
 

affected

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I would suggest that if you really think you have dysarthria it could be worth seeing a speech pathologist.

I will note however that mumbling is not a presenting symptom of bulbar ALS, slurring (like you have been drinking) and choking, particularly on clear fluids is. And yet, you will feel perfectly normal.

Try not to second guess everything, but do get someone who knows speech issues to check you.
 

Concernfarther1

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Hello everyone- i wanted to follow up to see if this is correct as to what my neuro says. I had an emg done in late April. Both arms, neck, legs, and under chin for bulbar. Everything was normal no muscle lost at all. I feel like my speech has been off, mumbling words. Went to speech pathologist that said i can do some motor strength exercises but said i don’t have dysarthria or aphasia, my question is my neuro ruled out als, i has some white spots show in t2 but said it’s not ms either. So with clean emg would bulbar als been ruled out? Been experiencing this for 4 months and read als can take year to diagnosis, would i be testing too soon?
 

Nikki J

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You had an emg that included a bulbar screen that was fine while you had symptoms. You were seen by the neurologist who found nothing of concern on exam. normal exam and normal emg that included a bulbar area rules out ALS yes. when ALS takes a year to diagnose it is generally because it takes that long for people to get to the right doctor. Many people do not go instantly to a doctor , when they do, depending on their presentation, they may get some treatment,blood tests or PT. After a while they go back and maybe get referred to orthopedics and then rheumatology. With long waits for appointments it takes months often before they even see their first neurologist. The ALS specialists actually have a campaign to get people with real, worrisome symptoms to them more quickly
 

affected

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I agree with Nikki here, ALS has been thoroughly tested for, and your speech concerns did not alert a speech pathologist who hears all kinds of speech issues and has a real ear for this.
You are not testing too soon, but you may now be hyper-focusing on the things that worry you.
I hope your doctor can help you work back to full health, do keep speaking to them about your concerns.
 

Concernfarther1

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Thanks everyone. Yes i been hearing that the normal emg, and all the spots he did should rule my fears of als and point to maybe something different for my speech issues, i did get diagnosed with cervical spondylosis myelopathy on my mri, but that would cause speech stuff. God bless everyone i appreciate you taking time answering my questions
 
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