Bulbar onset amyotrophic lateral sclerosis: A case report

Prasamsa Pudasaini; Shashank Neupane; Bishal Dhakal; Abilasha Rana; Bishnu Deep Pathak; Sagun Dawadi

doi:10.1016/j.amsu.2022.104889

Bulbar onset amyotrophic lateral sclerosis: A case report

Ann Med Surg (Lond). 2022 Nov 13:84:104889. doi: 10.1016/j.amsu.2022.104889. eCollection 2022 Dec.

Authors

Prasamsa Pudasaini¹, Shashank Neupane¹, Bishal Dhakal¹, Abilasha Rana¹, Bishnu Deep Pathak¹, Sagun Dawadi¹

Affiliation

¹ Nepalese Army Institute of Health Sciences, Sanobharyang, Kathmandu, Nepal.

Abstract

Introduction: Amyotrophic lateral sclerosis is a rare progressive neurodegenerative disease that affects the brain and spinal cord nerve cells. The study highlights the role of early diagnosis and prognosis of bulbar onset ALS.

Case presentation: We present a case of 60 years old female who presented with slurring of speech with a deviation of tongue and progressive dysphagia. With the role of Magnetic Resonance Imaging (MRI), Electromyography (EMG) and Nerve Conduction Study (NCS), a diagnosis of ALS was made.

Clinical discussion: ALS is a progressive neurodegenerative disorder, and the presence of genioglossus muscle involvement at diagnosis implies a shorter survival. It mandates multidisciplinary aspects requiring a professional opinion from neurologists, speech therapists, otolaryngologists, and electrophysiologists for effective treatment. Edaravone has antioxidant properties which counteract oxidative stress leading to neuronal injury in patients with ALS.

Conclusion: ALS with bulbar onset can have a grave prognosis and hence requires a multidisciplinary approach toward effective treatment.

Keywords: Amyotrophic lateral sclerosis; Dysphagia; Fasciculation.

Publication types

Case Reports