upcoming EMG - Bulbar worry

[Pingle]

Hi. I understand the effort it takes to respond to so many queries and I admire the help, guidance and reassurance you give to the members on this forum but I would appreciate a little help if possible as I have fallen into a Google black hole.
I am a 47 year old male, sporty and generally healthy. In June of this year I had a heart issue which has now been resolved, however I became anxious about my health in the wake of the scare I had in June. My body was twitching all over for about two months but I really began to worry when the twitching moved to my lower lip. At this point I went to my PCP and he ordered an MRI. Scan was clear and he told me there were no signs of MS. The body wide twitches eased off and I got used to them but I still had issues with my lower lip. The only way to describe the sensation in my lip is slow contractions and if I purse my lips or puff out my cheeks my lower lip slowly squeezes in and out once it relaxes.
I ignored this until recently (3 weeks ago) when my tongue began to freeze on one side affecting my speech – I wasn’t slurring my words (like sounding drunk slurring) and had no issues with speed of speech. My wife noticed a small change in articulation of some sounds as my speech became more sibilant. My tongue on inspection would pit in one place and twitch slowly in and out while relaxed. A dip could be seen on my tongue for a minute or so and then disappear and I can feel it when it does this.

I went back to my PCP about this and he referred me to a Neurologist. The Neurologist conducted a physical exam and didn’t make any comment except that my left arm shot out on a reflex test. He did this a couple of times to recheck and then said it wasn’t a cause for concern. He suggested I get another brain MRI with contrast and a cervical MRI plus blood tests. He also scheduled me for a nerve conduction test and EMG in January. He said he wanted to check everything and draw a line under the whole thing. I did mention a concern about MND and he said you don’t have it. I never mentioned bulbar palsy (don’t know why).

My concern is that the tongue sensations are still there but they have come and gone. They may go for 2 days and then come back for 5 days. At night everything feels ok but as the day progresses my tongue gets more tired. I have sensations on the right side of my tongue that are hard to describe but it feels a bit like it’s twisting (though it’s not) and it’s a bit prickly feeling. I sometimes feel sensations under my chin and in my neck but I put that down to worry about my tongue. My jaw joints have twitched on several occasions really fast but it’s not noticeable when looking in the mirror – I put this down to perhaps clenching my jaw. There are no issues with breathing, eating or drinking. I can stick out my tongue and move it around. That being said I am wondering if this is an early sign of a bulbar problem? Is there atrophy on one side of my tongue that’s making the non atrophied parts work harder? Can the tongue atrophy in just one place? It does seem like one part of my tongue is frozen. There are no widespread fasciculations on my tongue when it’s relaxed, but sometimes it pits slowly when relaxed. I do have ongoing twitches and some stiffness in my calf, foot and hand on my left side but no obvious lack of strength. Part of me believes that stress/anxiety has brought this on, but the sensations I’m feeling are very real.
I have read the stickies and I’m aware what I’m saying contradicts what I’ve read so apologies for that. I have a long wait until my EMG and I would appreciate any guidance you could give me on this.
thank you

 

[affected]

I did mention a concern about MND and he said you don’t have it.

You are not describing ALS even a little bit which is great news.
To answer all those questions in the last paragraph - NO.
January isn't really very far away, most of us had to wait months, so we understand that is normal.
In the meantime do all you can to stay hydrated, exercise, sleep well, and eat well. Remember to keep living and concentrate on what you have and don't waste the next couple of months on what you think you might have. It's all up to you really.
All the best.

 

[Pingle]

You are not describing ALS even a little bit which is great news.
To answer all those questions in the last paragraph - NO.
January isn't really very far away, most of us had to wait months, so we understand that is normal.
In the meantime do all you can to stay hydrated, exercise, sleep well, and eat well. Remember to keep living and concentrate on what you have and don't waste the next couple of months on what you think you might have. It's all up to you really.
All the best.

Thanks for getting back, especially so quickly! Yes, the waiting is difficult but I’ll try to stay positive. Thanks for the advice. It’s difficult to get the worst case scenario out of your head once it gets in regardless of what the neurologist said I don’t think I asked enough questions when I was with him. I would have liked to know if bulbar symptoms come and go.
I suppose it doesn’t matter now as it seems I’m way off the mark in terms of what I thought it was.
As I said earlier I am feeling very odd and troubling sensations in my tongue and lower lip so it’s hard to ignore it.
Anyway thanks so much for your reassurance and for taking the time to respond.
Best wishes.

 

[affected]

ALS doesn't come and go, bulbar or otherwise, I'm sure the stickies have answered your major concerns as well as my replies here. The more you focus on this the more troubling sensations you will find. All the best.

 

[Pingle]

You’re absolutely correct. Thank you!