In about 25 percent of ALS patients early symptoms begin with bulbar involvement. Some 75 percent of patients with classic ALS eventually show some bulbar involvement.
Involvement of extraocular movements is usually rare. Bulbar impairment is indicated by dysarthria, dysphagia and facial diplegia.
[…] palsy also called progressive bulbar atrophy, involves the bulb-shaped brainstem - the region that controls lower motor neurons needed for swallowing, speaking, chewing,