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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Neurology
Satisfied Customers: 18199
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I am not sure how this works. I, like others on this thread,

Customer Question

Hello, I am not sure how this works. I, like others on this thread, have a fear of als. Currently my fear is of bulbar. I honestly think it is anxiety related, but could use some reassurance today...
Submitted: 6 months ago.
Category: Neurology
Expert:  Dr. David replied 6 months ago.

Hello, this is Dr. David. I am reviewing your question now and will be with you momentarily.

Expert:  Dr. David replied 6 months ago.

ALS is a very rare neurological disorder.

why are you worried about ALS

many patients who have anxiety symptoms can have benign fasciculations and twitching which in 99.999% of the time is not due to ALS.

are you getting treatment or medications to help with anxiety symptoms?

Customer: replied 6 months ago.
I should add... body wide muscle twitching for 4 months. Clean emg two months ago. Seen two neurologists have both said not als. I know it's a fear and likely unfounded.Had two major flare ups of acid reflux in the last two months. Obsessive swallowing. No issues swallowing food or drink, just saliva. Left Ear feels plugged. Hear a clicking in throat sometimes.
Customer: replied 6 months ago.
I am seeing a therapist for anxiety and am going to speak with dr about starting some meds for that soon. Did not have anxiety issues until after twitching started. (Neuros both say present as classic bfs). Just concerned about swallowing issues now as these started after neuro visit.
Customer: replied 6 months ago.
I'm not sure if you're getting these.... (again, not sure how this works or if I'm doing it right)
Expert:  Dr. David replied 6 months ago.

you should talk to your doctor about medications which could help decrease your anxiety symptoms.

your symptoms don't sound like ALS

Customer: replied 6 months ago.
Ok thank you. I know... als swallowing issues would present differently, correct? And usually speech issues first...Trust me, i realize I sound ridiculous... just need as much reassurance as I can get.
Expert:  Dr. David replied 6 months ago.

it sounds like your anxiety symptoms are out of control.

you should talk to your doctor about medications which could help decrease your anxiety symptoms

ALS progresses and takes away your speech and motor functions and walking

you are letting your anxiety symptoms get out of control with worry here.

Customer: replied 6 months ago.
ok. Thank you
Expert:  Dr. David replied 6 months ago.

let me know if you have other questions.

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Expert:  Dr. D. Love replied 6 months ago.

The system says that you have requested another answer.

What additional information are you seeking?

Customer: replied 6 months ago.
I would like some more specific info as to how my issues don't point towards ALS....
Customer: replied 6 months ago.
Looking for something to help ease my anxiety, rather than just telling me that anxiety is my problem. (Which I am aware)
Expert:  Dr. D. Love replied 6 months ago.

While I agree that ALS is rare and that the symptoms are not the typical presentation for ALS, the greatest reason why I do not think that it is ALS is that there was apparently no findings on neurologic exam by two different Neurololgists that was worrisome for ALS and the EMG was normal.

Customer: replied 6 months ago.
MAkes sense. I did not have the swallowing issues (I believe brought on by my bad acid reflux flare ups???) until after those appointment.... but that wouldn't make sense for neuros to clear me and then suddenly something else flare up that was als related, correct? One said that with body wide twitching, I would display a whole host of other symptoms that I did not have...
Customer: replied 6 months ago.
In the span of a few weeks things keep changing. One symptom gets better and then another pops up.... I am guessing anxiety related again.
Customer: replied 6 months ago.
Ie. ball in throat and classic reflux symptoms, then sore throat, then throat feeling tight, then clicking noise and popping ears, now some nasal drip....
Customer: replied 6 months ago.
One will go away and then other starts. Not all on top of each other. If that makes sense
Expert:  Dr. D. Love replied 6 months ago.

Yes, the Neurologist referencing the other usual symptoms is the same as the above statement that the symptoms are not the typical presentation, but the Neurologist also has the advantage of being able to perform a neurologic exam to also indicate that it is not the usual presentation.

Yes, it is common anxiety symptoms can fluctuate frequently, so yes, it makes sense from the perspective that anxiety is causing your symptoms.

.

Customer: replied 6 months ago.
Ok thanks...
Expert:  Dr. D. Love replied 6 months ago.

You are most welcome.

Please remember to provide a positive rating so that I am credited for assisting you.

Customer: replied 5 months ago.
Hello again. I have more to ask... I have noticed my uvula is hanging to one side. Is this of concern???
Customer: replied 5 months ago.
When I say "ahh" it doesn't really move at all...
Expert:  Dr. D. Love replied 5 months ago.

It is probably not a concern, but to be able to definitely answer that question, it would require an examination. Did your doctor look at this?

Customer: replied 5 months ago.
Hasn't yet. Gag reflex on both sides is fine...
Customer: replied 5 months ago.
What else would you examine?
Expert:  Dr. D. Love replied 5 months ago.

If the gag reflex is fine, then it is even more likely that the palate and uvula are not a concern.

I would do a neuro exam, which assesses each component of the nervous system.

Customer: replied 5 months ago.
Anything I can test myself? also, is it possible that this is caused by my LPR (likely) sore throat and irritated mouth?
Expert:  Dr. D. Love replied 5 months ago.

No, not really. A neuro exam would need to be done by a doctor.

It is common for LPR to cause mouth and throat irritation and inflammation, and this can cause the uvula to deviate to one side.