Bulbar onset amyotrophic lateral sclerosis: A case report. (December 2022)

• Record Type: Journal Article
• Authors: Pudasaini, Prasamsa; Neupane, Shashank; Dhakal, Bishal; Rana, Abilasha; Pathak, Bishnu Deep; Dawadi, Sagun
• Is Part Of: Annals of medicine and surgery. Volume 84(2022)
• Publication Date: 2022-12
• Subjects: Amyotrophic lateral sclerosis -- Dysphagia -- Fasciculation; Surgery -- Periodicals; Medicine -- Periodicals; General Surgery -- Periodicals; Education, Medical -- Periodicals; Periodicals; 617
• DOI: 10.1016/j.amsu.2022.104889
• Languages: English
• ISSNs: 2049-0801

Abstract

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. Highlights: Amyotrophic lateral sclerosis is a progressive neurodegenerative disease that affects brain and spinal cord nerve cells. Presence of bulbar onset can lead to poor prognosis. Professional opinion from multidisciplinary team is required for effective treatment.