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Updated: Aug 15, 2025

A Protocol for Comprehensive Assessment of Bulbar Dysfunction in Amyotrophic Lateral Sclerosis ALS
Published on: February 21, 2011
Bulbar onset amyotrophic lateral sclerosis: A case report
Prasamsa Pudasaini1, Shashank Neupane1, Bishal Dhakal1
1Nepalese Army Institute of Health Sciences, Sanobharyang, Kathmandu, Nepal.
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.
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