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.

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.

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.

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.

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

Amyotrophic lateral sclerosis

Dysphagia

Fasciculation

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