Intermittent Dysarthria and Functional Dysphonia

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tomb

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Learn about ALS
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Chicago
We've all heard the term "at least you have your health", and now this phrase takes on new meaning to me because I'm having a health issue that could be ALS.

It started about 15 months ago with a tight jaw, where I would take a bite of breakfast and it would be very hard to open my mouth to chew. After a couple bites, it would work itself out, and I could chew normally. Then in about April of 2022, I got COVID, and after recovering, I had a very hoarse voice that lasted for months.

Meanwhile, another symptom started in roughly May/June 2022: intermittent slurring of speech. Maybe once a day, I'd start to say something, and my tongue just wouldn't form the words correctly. This would last for maybe 10 seconds, and then I could talk normally. Finally, in Oct of 2022 I went to an ENT. He discovered a node on my vocal cords and a very irritated throat. He diagnosed Functional Dysphonia, referred me to a voice therapist, and prescribed something for acid reflux. He also said that intermittent slurring is not a symptom of Functional Dysphonia, and suggested I find a neurologist.

After a 4 month wait, I finally saw the neurologist last month. After a thorough exam, he says there is moderate weakness in my lower face, particularly my cheeks and tongue. He diagnosed intermittent Dysarthria of unknown cause and ordered blood tests and 3 MRI's on May 24th. The blood tests came back clean, but now he's ordered more blood tests.

The hoarse voice is gone, thanks to the voice therapy. The intermittent Dysarthria hasn't gotten worse in 9 months. Other symptoms: my cheeks have sunken on the left side of my face, and I feel tingling all the time on that side of the face. My right hand gets numb easily, but that is a problem I've had for 20+ years that I attributed to carpal tunnel, but now it seems like the left hand is starting to experience the same. I also practice jiu-jitsu which is very hard on the hands due to constant gripping of the opponents gi, so that could be at play too.

Last night I revealed all this to my wife, and she is terrified. So am I.
 
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Hi, Tom, try not to be terrified. I would think if your neurologist's first thought was ALS, you would have an order for an EMG instead of MRIs. Possible causes for your issues, as you are no doubt aware, range from post-COVID syndromes (of which Bell's Palsy, for example, is a known risk) to a tumor that I'd imagine the MRIs are in part to rule out. As you point out, the hand issues could be completely unrelated and often are.

Facial weakness and tingling do not sound like ALS onset, nor intermittent speech difficulties as you describe. You also have a prior ENT history. The planned testing seems appropriate given what you have shared. So I would live your lives, knowing that it will soon be clearer what you are dealing with.

Best,
Laurie
 
Hi Tom. Does your wife notice the dysarthia? Did the doctor hear it?

Certainly having it not get worse in the last 9 months is good and points away from ALS.
 
Hi Robin, my wife has not noticed the dysarthria, mostly because I'm able to slow down my speaking when the dysarthria happens. Thanks for your comment.
 
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