Bulbar issues - Need your advice

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Bulbar issues - Need your advice

Postby Pascal35 on November 15th, 2014, 10:44 am

Hi everyone,

We are just 10 days after a clean EMG on both arms performed by a top Neurologist and i started having new issues again.
The last 3 days i realized that my speech becomes difficult and strange when my level of anxiety and stress is high.
When i am on meetings some words become difficult to pronounce especially when i speak quickly. In addition i have a feeling of fatigue (slight pain) on both my zygomaticus muscles (top inside cheek muscles) when i talk or smile.
This is noticed only by myself at the moment. I am thinking too much when i am starting to talk and my fear of slurring the words raises the level of anxiety.
We are 12 months since the beginning of my initial twitching and i still can't get ALS out of my mind.
At least i haven't noticed any tongue twitching yet even though i had tongue twitching in the past and also had clean EMG a 3-4 months ago in my tongue.
Has anyone else experienced similar issues...?
Does anyone know how the slurring onset feels like?
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Re: Bulbar issues - Need your advice

Postby Yuliasir on November 15th, 2014, 11:17 am

Pascal, I hope you would not end up with the needle in your tongue this time :)
This is not a bulbar onset in no way.
Bulbar onset involves nerves whch innervate tongue and throat, and practically deficites are not like having difficulties to spell certain words on the meeting.
Practically true bulbar onset might be in various forms like rapid complete loss of speaking ability (rerpoted here for the relative of one of the fellows), loss of vocal tone (voice beocmes flat or crooky like in people after stroke), locc of ability to speak in loud or low voice (one can not nay more change a voice pitch deliberately), and also disruption of swallowing reflex (inability to initiate swallowing act due to the fact that throat is closing under the pressure of food or saliva instead of being opened) is coming quite soon that is why peole in bulbar onset quickly become dependednt on tracheostomy and parenteral feeding.

What you describe is just a result of anxiety and stress, you have muscle strains but not a bulbar symptomes.

What is your plan for main root cause (I mean anxiety disorder)?
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Re: Bulbar issues - Need your advice

Postby Pascal35 on November 15th, 2014, 1:16 pm

Thanks Yuliasir,

Your input is once again very helpful.
I am so worried again with these issues. My facial muscles (zygomaticus) seem to get fatigued when i am speaking... I feel that i have to put extra effort for my voice to come out. I eat and drink normally.
Gladly there are no twitches etc..
I had tongue EMG quite a few times over the past 12 months :-) (last time end of July) so i guess it won't make a difference.
Well, if i think logically then ALS shouldn't be still a concern.
12 months ago twitching in right bicep. Then spread throughout the body. Several EMGs - NO ALS.
Then tongue twitches. EMGs - NO ALS. Again arms and legs EMGs - NO ALS.
So how can it be possible to have now Bulbar onset??? Normally the onset should have been limb if the twitches were "pathological"... So since the twitches were not "pathological" then there is no ALS issue to discuss.
How does this theory sound to you?
And finally - To answer to your question regarding my anxiety. I was taking Xanax for several months (0.5mg daily) and stopped 10 days ago (after my clean EMG) - I also tried antidepressants but didn't seem to work with me. Its really tough to get over it.
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Re: Bulbar issues - Need your advice

Postby Pascal35 on November 16th, 2014, 8:23 am

Well. I guess no one else has same symptoms.
Basically my facial muscles get tired (feel this slight fatigue pain) easily when I whistle or talk a lot.
At the moment I haven't noticed. Any weakness but maybe this is the starting phase.
I do have TMJ but I don't think that zygomatic muscles are involved in TMJ.
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Re: Bulbar issues - Need your advice

Postby LKP1231 on November 16th, 2014, 9:10 am

Your emgs have all been clean. That's it. You don't have als. It would show up absolutely.
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Re: Bulbar issues - Need your advice

Postby Jayden on November 17th, 2014, 7:05 pm

Lol, I got same symptoms plus voice hoarseness,
my slurred speech is crazy, my wife told me to slow up.
When I speak I have trouble with R or M and L.
BUT I can pronounce them when I speak, slowly.
I feel my tongue is heavy.
plus jaw pain, face twitching.
I get of chewing.
The more you notice the worst it gets.
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Re: Bulbar issues - Need your advice

Postby physerv24 on November 17th, 2014, 8:31 pm

Jayden,

Did you go see an ENT? How did it go?

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Re: Bulbar issues - Need your advice

Postby Pascal35 on April 19th, 2015, 1:30 am

Hi Jayden,

So whats your latest news.
Are your symptoms getting better?

Regards
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