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Dr. Andrew Rynne

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What are the symptoms of ALS?

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Dr. Sumit Bhatti

ENT Specialist

Practicing since :1991

Answered : 2569 Questions

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Posted on Mon, 19 Oct 2015 in Ear, Nose and Throat Problems
Question: I noticed that when I stick my tongue out that it twitch's or shakes but when it is at rest in my mouth it is fine does this mean I have als.

Thanks XXXXXXX
doctor
Answered by Dr. Sumit Bhatti 2 hours later
Brief Answer:
No, this is common.

Detailed Answer:
Hi,

Thank you for your query.

1. No, this observation of tremulousness of the tongue when stuck out and no problem when relaxed in the mouth is common and not a sign of ALS.

2. ALS will lead to progressive signs and symptoms. For example, slurring of speech, difficulty in swallowing and breathing will be present.

3. As a single observation, this carries no significance.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Sumit Bhatti 44 hours later
when I sit on the floor with my arms stretched out behind me to support my back my arms start to shake after about 10 seconds is this something that could be a sign on ALS or Ms or is this normal.

Thanks,
XXXXXXX
doctor
Answered by Dr. Sumit Bhatti 4 hours later
Brief Answer:
Highly unlikely to be the presenting symptom of ALS or MS.

Detailed Answer:
Hi,

Thank you for writing back.

1. This is a common symptom of weakness.

2. This is definitely not an initial symptom of ALs or MS.

3. Consult a Neurologist who deals with movement disorders. Rule out early Parkinson's Disease and Benign Essential Tremors.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumit Bhatti 1 hour later
sometimes when I am lying down I have muscles in my upper and lower leg plus muscles in my biceps that twitch periodically and sometime feels like a motor running inside my body. I do not have any problems with speech or swallowing at this point or going up and down stairs sometimes I feel like my balance is off but maybe it could be the medication he prescribed ( 30mg of Mirtazapine), just wanted to see what you make of these problems can stress have a lot to do with this symptoms.
I had a MRI done about 3 weeks ago and my doctor gave me the results and they came back inconclusive is that anything to worry about also I had a few concussions 10 plus years back playing hockey.

Thanks for you time ago XXXXXXX
doctor
Answered by Dr. Sumit Bhatti 8 hours later
Brief Answer:
Taper the mjrtazepine and review the medication with your doctor.

Detailed Answer:
Hi,

Thank you for writing back.

1. The trembling feeling (motor running inside the body) is most likely drug induced due to the side effects of mirtazepine. Tapering off mirtazepine can help decide this.

2. The MRI Scan will not miss any demyelination or brain changes linked with MS and ALS. Hence a normal MRI is is a good sign.

3. Slight imbalance is common in the sixth decade of life and the old concussions may have a role in this. Check if the imbalance is positional (on lying down or getting up).

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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