Are my symptoms early ALS/bulbar?

LaceyB

New member
Joined
May 11, 2025
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Learn about ALS
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UK
Hi all,
27 F. I’m extremely anxious I have early signs of ALS, to the point I’ve convinced myself i have it. I would appreciate any education/advice. This is what I’ve been experiencing:

September 2024
Pain in my left shoulder shortly followed by noticing/feeling a slight tremor in my left arm (not really noticeable by others).
I have had ongoing little twitches all over for a couple of years, nothing extreme just the odd eyelid/arm/leg.

End of October 2024
General doctors appointment as I had concerns about my twitching and brain fog I was experiencing. She did blood tests and neuro test which showed nothing abnormal. I raised ALS at the time.

March 2025
Shoulder continued to ache and feel heavy but I continued with sport and had no issue with weakness. Slight tremor still noticeable to me only. Pain began to move to upper/mid arm.

Mid April 2025
Noticed a big increase in my twitching in April. It was more noticeable. This then settled on my calves with 24/7 twitching sensation/constant vibrating. After a week it remained on my left calve only and has been continuous ever since. I developed a ‘pre cramp’ feeling in the left calve also. This leg feels a bit shaky. Brain fog and fatigue also experienced.
This caused a massive spike in my anxiety and I began to spiral. I haven’t been able to eat properly in the past week, multiple anxiety attacks a day. Three days into this I noticed tounge twitching, I believe also at rest, I have a cramp feeling at the the back and sides of my tounge causing my mouth/tounge to ache, I have become very aware of my ability to swallow which feels more work than usual. Tonsils/mouth/jaw feels so tingly and it’s an odd feeling to move my tounge and effort to talk, also the feeling of indigestion. No slurring. I have been thinking back over this year and there were a few occasions I have woken in the night from a coughing fit or drank the wrong way resulting in a coughing fit. I’ve also noticed I’ve woken a few times with my jaw partially open. I’m terrified that I have the start of bulbar ALS. Could it appear like this overnight?
I have also noticed an increased vibration in my left arm, under my mouth and in addition to my left leg. I also have a lot of little twitches around my lips, mouth and chin
As far as weakness, I haven’t failed to do anything. I feel generally weak but this is due to poor eating and extreme anxiety. No trips or falls, no dropping anything. I worry this is the beginning and these things will follow.
I’m not sure what I’m looking for with atrophy. My left bicep is a bit smaller than my right.

I have a doctors appointment tomorrow which I’ve waited too long for (UK based). I’m just feeling so incredibly nervous and looking for some support/advice. Thank you all so much.
 
I think your visit will be reassuring as regards ALS. I would discuss allergies and GERD as possible issues at your appointment, and maybe a trial of physio for your arm. You might also discuss ways to achieve more refreshing sleep, and track your own sleep with a wearable for a few nights to see if there is excessive movement, normal O2, etc. There might be data that suggest a sleep study.

Nutrition, hydration, and sleep are all key in twitching/cramps, often, even in your tongue that can get very dry and irritated, especially if you are sleeping with your mouth open.
 
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