Regarding Pseudo Bulbar Palsy,

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perplexed

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Does anyone know if Pseudo Bulbar Palsy HAS to present with emotional lability? I've had three different responses from three neuros.
Thanks,
Perplexed
 

olly

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no not really.some it may be ott,others hardly noticable or not at all.
i have umn bulbar involvement,only occasionally i have had problems with laughing or crying.
the most troublesome symptom i have is excessive yawing when the jaw spasms are really bad.

ps.......i can have the odd mood swings/completely loose it moments.
i think bethu does as well ,but we both agree these are ok and justified.
 

Jennifer51

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I too have more problems with excessive yawning...as for emotional liability (I am bulbar) I find it hard to differenciate...I have days when I am fine (mentally) and fight this all the way, then I have moments when all I want to do is sob, hit out at things and just want to end it...I am sure this is in part, when, for who knows what reason, the reality of what we have strikes home. I think we we are ALLOWED to be angry and depressed about it. Do I have emotional liability? I dont know, I think I am having a natural human reaction. I appreciate some people do have full emotional liability, if I have it, I consider it is only mild, it must be dreadful to have it big time.
 

perplexed

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I think the neuros mean more of an uncontrollable reaction

Thanks everyone,
I think what they mean by "lability" is an abrupt, almost uncontrollable swing from at-rest-to-laughing-or-crying, not your entirely justified mood swings.

THey seem to be using emotional lability as a diagnostic tool for differentiating pseudo bulbar palsy from UMN Bulbar ALS.
 

Jennifer51

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my diagnosing neuro based his diagnosed on the results of my emg and the other electrical test done at the same time, know the name,mind has gone blank. He said it was cast iron evidence of pseudo bulbar, he didnt even mention emotional liability ,
 

perplexed

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Jennifer, that's interesting,

Just shows how much variance there is in science. The neuro here was categoric on her reason for defining pseudo bulbar palsy as requiring emotional lability.

When you say your EMG results, did they show something specific?

Because my husband's have been clean (so far), which either indicates only UMN involvement, or a stage in progression that doesn't yet show LMN involvement.

Thanks so much,
Perplexed
 

perplexed

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PS Jennifer

Talk about minds going blank.... I forgot - two seconds ago! - to ask you what your initial and then other symptoms were.
Cheers,
Perplexed
 

Jules45

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Jennifer & Perplexed. Couple of questions:

-How do you define "excessive yawning"?
-What type of cramping, if any, did you experience?

Thanks and God Bless.
 

olly

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jules45
excessive yawning=feeling the need to yawn ofton especially throughout the day when you are not tired,so i would really say is involintary yawning.

emotional liability is a umn symptom is it not?
that is why many with pls have it.
 

Jules45

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Olly, I find myself yawning often too. You mention having jaw spasms. I don't think I've had those. What are those.

I've had clean EMG's on my legs and neck and my neuro's tell me not to worry about ALS but I'm concerned about UMN or Bulbar.

Thanks and God Bless.
 

Jennifer51

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The first symptoms I had, ( or thought they were the first)...was slightly slurred speech, liquids spurting out the wrong way, my tongue then felt wierd and I needed to swallow much more. The speech then slowed down a lot and continuously swallowed whilst trying to talk.
Once I knew what was wrong with me, and on learning more about it, I did recall that long before all this happened i was getting cramps every morning when I woke up and stretched...just thought I was getting older, and for about a year my husband had been telling me to go to the doctors as I was ALWAYS yawning uncontrollably especially when on the phone.
My needle test as the neuro called it...I dont know any details about it...I know it was very noisy the whole way through..apart from when he did it under my chin. When I was told the result, he just said cast iron evidence of pseudo bulbar palsy, I had just had the spinal tap done, and was so upset and didnt know about emg and results, that I did not ask anything. Everything had happened over the course of 2 weeks from the first time I saw the gp...we twigged what was the possible diagnosis was from the first time I saw the neuro, from something he said...rang a bell as we know someone with limb onset als...and tests etc started to sound familiar...so we asked him straight out. The worst thing is he said yes. So in my and my husbands mind I went from being fine to terminally ill in 2 weeks.
 

Jules45

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Jennifer thanks for your response. I wish you the best moving forward.

The EMG/needle test he did, was it on all your limbs, or just your arms and/or face?

Did your Neurologist look at your tongue when he first looked at you?

Thanks and God Bless.
 

Jennifer51

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My GP looked at my tongue and saw immediately that he suspected mnd/als. The neuro heard me talking and immediately suspected the same. My tongue has fascilations when pocked out. As my gp said, my tongue looked like it was full of wriggling worms and he had seen that once before and the person had MND. The EMG and the other test were done on my whole body, but only down one side. The room was too small for him to do the other side. so my arms legs abdomen and under my chin were all done.
 
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