Elaborate Tongue Fasciculations Going Down to the Neck: A Rare Case of Sporadic, Young-onset Amyotrophic Lateral Sclerosis with Bulbar Symptoms, from Pakistan

Nusrat, Khushboo; Mahmood, Samar; Marsia, Shayan; Mahmood, Khalid

doi:10.7759/cureus.4600

Cited by 3 publications

(6 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, it is important to ask about family history when interviewing the patient, as 10% of ALS cases are familial in origin. 2 Finally, there is an ALS functional assessment scale (ALSFRS-R), which has become a clinical prognostic marker for clinical and research purposes in amyotrophic lateral sclerosis (ALS). Some teams are trying to develop tools to predict disease progression; however, because some patients have a slow rate of progression, attempts at models are not yet applicable.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, it is important to ask about family history when interviewing the patient, as 10% of ALS cases are familial in origin. 2 …”

Section: Discussionmentioning

confidence: 99%

“…In 10% of cases, the form is familial, and the remaining 90% are sporadic. In both cases, there are two types of development of the pathology: the bulbar and the spinal form 2 …”

Section: Introductionmentioning

confidence: 99%

“…In both cases, there are two types of development of the pathology: the bulbar and the spinal form. 2 One of the early clinical signs of this pathology is the presence of fasciculation, especially in the tongue, which can be diagnosed by dentists. A lingual fasciculation is characterized by involuntary, uncontrolled, and constant movements of the tongue.…”

Section: Introductionmentioning

confidence: 99%

“…In both cases, there are two types of development of the pathology: the bulbar and the spinal form. 2 …”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Lingual fasciculation: A point of call for the diagnosis of amyotrophic lateral sclerosis

Galeazzi

Holzman

Mondoloni

et al. 2023

Clinical Case Reports

View full text Add to dashboard Cite

A 60-year-old female patient, with no notable medical history, was referred by the internal medicine department for a dry mouth workup. The clinical examination revealed an absence of dryness, and the presence of lingual fasciculations, associated with difficulties in mastication and phonation. These symptoms appeared spontaneously 9 months before the consultation, after leaving confinement. Given the presence of lingual fasciculations, the diagnostic hypothesis of a neurological pathology, in particular amyotrophic lateral sclerosis (ALS), was suspected. After performing an electromyogram (EMG), the diagnosis of ALS was retained. Riluzole treatment was then started, and physical therapy sessions were scheduled. Riluzole allows an average gain of 4 to 6 months of life expectancy. Speech therapy and physical therapy allow to maintain the functions as long as possible and to improve the end-of-life conditions. The interest of early detection of ALS allows delaying the progression of the disease.

show abstract

Section: Discussionmentioning

confidence: 99%

“…In addition, it is important to ask about family history when interviewing the patient, as 10% of ALS cases are familial in origin. 2 …”

Section: Discussionmentioning

confidence: 99%

“…In 10% of cases, the form is familial, and the remaining 90% are sporadic. In both cases, there are two types of development of the pathology: the bulbar and the spinal form 2 …”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…In both cases, there are two types of development of the pathology: the bulbar and the spinal form. 2 …”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Lingual fasciculation: A point of call for the diagnosis of amyotrophic lateral sclerosis

Galeazzi

Holzman

Mondoloni

et al. 2023

Clinical Case Reports

View full text Add to dashboard Cite

show abstract

Dental Management of Patients With Amyotrophic Lateral Sclerosis

AlMadan,

AlMajed,

AlAbbad

et al. 2023

Cureus

View full text Add to dashboard Cite

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease that affects the upper and lower motor neurons with upper and lower motor neuron manifestations. It is divided into two variants: a spinal onset and a bulbar onset. The first starts as focal muscle weakness and wasting that spreads with disease progression, while the second phenotype presents with dysarthria, dysphonia, and dysphagia. Moreover, an extra-motor manifestation could be reported with the most commonly reported symptoms being the change in cognition and sleep disorder. Oral manifestations include increased salivation, limited mouth opening, and dysphagia. Patients with ALS have difficulty maintaining oral hygiene, and it is important for the practitioner and the caregiver to take care of this group of population. We herein provide a short review of the disease with a focus on the oral manifestations and dental considerations for management for this group.

show abstract

Lingual Fasciculation as a Point of Call for the Diagnosis of Amyotrophic Lateral Sclerosis: A Literature Review

Galeazzi,

Holzman,

Porporatti

et al. 2024

Cureus

View full text Add to dashboard Cite

Background and aim: Dental surgeons often play a pivotal role in the initial detection of lingual fasciculations (LFs). These involuntary micro-movements of the tongue can serve as early clinical indicators of neurodegenerative diseases, with amyotrophic lateral sclerosis (ALS) being the most concerning. Therefore, it is imperative to educate dental surgeons on identifying LF and understanding the potential underlying pathologies. Objectives: This study aimed to pinpoint the pathologies in which LFs could emerge as an early clinical marker. Our review focused on articles delineating patient populations exhibiting LF within broader pathological contexts, encompassing neurological and other conditions, with the aim of elucidating their etiologies. Methods: We conducted a comprehensive literature review across four databases (PubMed, Embase, Web of Science, and Scopus). Two authors independently extracted data, with consultation from a third author when necessary. Eligible articles included those describing patients with LFs, detailing the methods of detection, diagnosis, and associated pathologies. Results: Our review identified 22 articles encompassing 153 patients with LF, with an average age of 45.8 years and a female prevalence of 43%. Electromyography and ultrasound emerged as the predominant detection methods. ALS constituted the primary diagnosis in the majority of cases (91%). Additionally, other conditions diagnosed included Machado-Joseph disease (0.046%), familial transthyretin amyloid neuropathy (0.013%), Brown-Vialetto-Van-Laere syndrome (0.006%), chronic inflammatory demyelinating polyneuropathy (0.006%), bulbospinal amyotrophy or Kennedy's disease (0.006%), and osmotic demyelination syndrome (0.006%). LF secondary to organophosphate poisoning was also documented. Symptoms associated with LF encompassed taste alterations, dysphagia, difficulty swallowing, and slurred speech. Conclusion: While primarily indicative of ALS, LFs may also signal diverse underlying pathologies. Healthcare practitioners should be vigilant in their detection and expedite patient referrals to facilitate early integration into care protocols.

show abstract

Elaborate Tongue Fasciculations Going Down to the Neck: A Rare Case of Sporadic, Young-onset Amyotrophic Lateral Sclerosis with Bulbar Symptoms, from Pakistan

Cited by 3 publications

References 16 publications

Lingual fasciculation: A point of call for the diagnosis of amyotrophic lateral sclerosis

Lingual fasciculation: A point of call for the diagnosis of amyotrophic lateral sclerosis

Dental Management of Patients With Amyotrophic Lateral Sclerosis

Lingual Fasciculation as a Point of Call for the Diagnosis of Amyotrophic Lateral Sclerosis: A Literature Review

Contact Info

Product

Resources

About