Worries about Bulbar symptoms

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Purpleflowers16

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Aug 23, 2022
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Learn about ALS
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UK
I’ve read the post at the top of the forum but I would like to ask if anyone thinks this sounds like anything to worry about?

I have had muscle fasciculations that have been mainly in my legs for just over 4 months now, I had a clean Neuro exam last month and he did an EMG for my own peace of mind even though he didn’t think I needed one.
EMG was done in 4 limbs -
(Left tibialis ant
Right tibialis ant
Left Gastroc med h
Right gastroc med h
Left vastus lat
Right vastus lat
Left ext dig com
Right ext dig com
R biceps brach)
including the legs that were the most symptomatic with twitching 24/7.
Results were perfectly normal.

This was a massive relief and I went about my days forgetting about the twitching in my legs which has ironically since subsided.

However over the last few days I’ve been experiencing a strange sensation in my throat when swallowing like a lump licking sensation/something I can feel to the side of my throat when swallowing.
I can drink liquids fine and down a pint of water.
I’m just wondering if you could answer a couple of questions based on my info please? I very much appreciate it.

1 - Would an EMG test pick up Bulbar als if it was done on limbs that were fasciculatiing? Even if I didn’t have bulbar symptoms at the time of the EMG?
2 - Does bulbar start with a feeling of tightness, something strange in your throat when swallowing intermittently?

Thank you for your time 😊
 
1) An EMG picks up ALS, full stop, wherever the site of onset. In ALS, the EMG shows multiple sites of motor neuron damage, not just where the person first thought there was an issue. So a clean EMG very much argues against ALS, especially with multiple areas of concern.
2) No, you are describing globus pharyngeus, which can have many causes but often worsens in times of stress.

I would work with your GP and look to improve your nutrition, hydration, sleep, exercises and stress.

Best,
Laurie
 
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