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RLMunster

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Mar 9, 2017
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12
Reason
Learn about ALS
Country
SP
State
Leon
City
Villablino
Hello. First of all I'm sorry for all that got diagnosed with this terrible disease, my prayers are with you.
I'm very concerned about having this disease because I've been noticing the past few days I'm having some trouble speaking some words are hard to speak, I don't now if it is slurring or not. Noone commented but I feel something is wrong. My tongue is strong. I had a neuro appointment 2 weeks ago and that was clear... No babinski, normal reflexes (slightly brisk but normal) and no fasciculations in tongue. Neuro said EMG was not needed because I show no signs of ALS...
So what can be causing these speaking issues? I know I'm not speaking normal I can clearly tell I have difficulty getting some words right.
I can say papapa kakaka tatata and lalala fast by the way.

So my quick question is: Can slurring come before weakness in tongue or does weakness always precede slurring?
Also should I get an EMG even though neuro thinks it's not needed?
 
If no one has commented, are you sure you're really slurring? You might ask, or record yourself over time with your phone.

Weakness would generally precede slurring, yes, but before jumping to a fatal disease, I would work on hydration, sleep and stress since you had a normal neuro exam.

Best,
Laurie
 
I'm not sure this is slurring, I just have trouble with a few words... I told my neuro I struggled to speak some words right and he wasn't worried...
Also I don't know if that neuro is any good, I mean he did the babinski test with socks on...
 
If you question the experience of the doctor, see another. There's not much we here can do as potential neurological symptoms need to be assessed in person by a medical professional.

Frankly, your comment about conducting a test with socks indicates you do not accept the experience of your testing doctor. I have been tested for reflexes every 4 months for the past 2 years to track my progression. Only once did I take my socks off- and only because it was the dead of summer and I was roasting hot. Socks do not make a difference. Socks do not interfere with reflexes.
 
I'm not questioning the experience I thought socks made a difference, thanks for clearing that up.
I don't have any tongue weakness, in fact I believe it's strong (I can push my cheeks, put it in and out fast, touch every tooth with it) so I don't know why I'm having so much trouble saying some words. And it's not only a few times.... Imagine i was trying to say a word and it came out sounding weird, then I try to say that word again and it takes effort to pronouce it correctly. I don't know why this is happening because my tongue is strong...
So my question is: Should I be seeing a neuro again or because my neuro exam was normal there's no need to see another and this is not ALS?
From what I've seen slurring in ALS is caused by weakness in tongue and I don't have that so it should point away from ALS right?
 
That sounds like hypervigilance. The more conscious of the mechanics of speaking, the more likely it will feel odd. As others have posted, record yourself. Do it regularly to track possible changes. However, there are SO MANY things that cause issues with speaking- it's really odd to head straight for a terminal disease and bypassing the many issues that cause speech issues. If you cough, do you think you have lung cancer? This is the equivalent.
 
So general opinion is that with a normal neuro exam and no tongue weakness this points away from ALS?
I'm scared because I looked online and the first cause for speech issues is most of the times ALS or Brain Tumor, and Brain Tumor I don't have because i had a CAT scan a few months ago, so that's why I'm so scared...
 
Anxiety can cause speech issues exactly as you have described. As you like looking things up on dr google, type in " can anxiety cause speech issues" you will find lots of examples of exactly what you are describing. With a normal neuro exam you can relax as far as als is concerned.

Keep working with your doctor to ease your health fears.

Wendy
 
I'm trying to relax but it's not easy...
After lunch today while I was talking to my mother some words were hard to speak and she actually noticed it this time and commented. Of course I got terribly anxious again.
My tongue is strong and fast so I don't know why I'm having so much trouble saying some words. I know anxiety can cause that but usually with anxiety you try to say those words again and they come out right but in my case it takes a lot of effort to say some words.

I know in ALS people start to slur speech because the tongue gets weak and my tongue is not weak. Also 2 weeks ago at the neuro he said he saw no fasciculations.
(I haven't looked at my tongue after that because I know that if I see even one twitch I will probably freak out)

So I'm really lost and don't know what to think...
My speech issues are real and definitely there and I don't know what to do, I guess I will go to another Neuro and have an EMG done for peace of mind.
 
What I would like to know is: When people with ALS start to slur words the tongue is already weak\hard to move\slow or does slurring happen before any kind of weakness can be noted?
Thanks all in advance.
 
Hi Munster.

Honestly, from reading all you've written, I think it's not a good idea to answer. Some people subconsciously "get" the symptoms they hear about. That's a horrible way to live.

Three smart and experienced people--plus me, plus a neurologist--have said you don't need to worry about ALS. Be glad. If you have further questions, please ask your medical doctor.
 
The thing is, I know I'm not imagining my symptoms, I'm pretty sure they're real. I can't speak some words perfectly they just come out kinda slurred...
Yes it's true the neuro saw nothing to be worried about but I'm afraid it's too early to be detected in a neuro exam. I can't get this off my head...
I've never been a very anxious person but now I'm constantly checking my tongue strength and see if I can move it fast and so far eveything seems perfect with my tongue which makes me confused because slurring without tongue weakness seems impossible, right?
 
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Hi
No one is saying that your symptoms are imagined or not real. What we are saying is that they don't sound at all like our experience of mnd. Your neurologist has said that your symptoms don't seem to be neurologically related. I am sure your problems and the worry they are causing you are very real.

It is worth taking a step back and going back to your general practitioner sit down and ask what they think it can be if they don't think als is on the table, and ask them to help you with the anxiety this is causing you while they investigate. Anxiety in itself has very real effects on your body and you need to make sure that is not getting in the way of your diagnostic process.

Good luck

Wendy
 
I slur occasional words for the following reasons:

Dry mouth
Canker sores
Cracked tongue in winter
Being tired
Distracted by something else I'm doing at the same time

And I'm not thinking about slurring, as you now are.

As you say, if weakness isn't the issue, ALS isn't, either. I would go out today and run yourself ragged so you can be ready for a good night's sleep. If your symptoms persist, you might see an ENT or dentist. But you're in the wrong place here.
 
Today I took 2 xanax pills to help with anxiety and hopefully help with my speech, but it didn't change anything, I'm still having trouble with certain words, they don't come out properly. I'm scared and I don't know what might be causing this, I wish so much this is not ALS but I don't know what to think, this is causing me terrible anixety. My tongue is still strong.
What would be some words I'd have trouble with if I was really slurring?
 
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