However, they also noted an additional 9 patients who had ‘multifocal' PLS with asymmetry but evolution of bulbar dysfunction, or with bulbar dysfunction as a presenting symptom
[karger.com]
dysfunction, wasting, pyramidal dysfunction, dementia, parkinsonism, and cerebellar, cortical, and sensory signs) for significant differences between the 2 patient populations
[doi.org]
METHODS: Six sites enrolled 41 patients who had pure upper motor neuron dysfunction, bulbar symptoms, a normal EMG done within 12 months of enrollment, and onset of symptoms
[ncbi.nlm.nih.gov]