Abstract

Amyotrophic lateral sclerosis is a rare progressive neurodegenerative disease that aff ects the brain and spinal cord nerve cells. The study highlights the role of comprehensive clinical diagnosis and prognosis of bulbar onset ALS.
Case presentation

We present a case of 75 years old male with PMH of Prostate Cancer , HIV who presented with slurring of speech with a deviation of tongue and hypokinetic dysarthria along with lower limb weakness and numbess. This is a unique case, which accurately represents the importance of looking at the entire clinical picture with proper physical examination, and considering the possibility of all the diff erential diagnosis.

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 eff ective treatment.

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