Speech disturbances

• Increased effort of speech

• Softening of voice after talking for sometime

• Slurring of speech

• Inability to speak for a long time with high fatigability

• Inability to speak

• Unintelligible speech

• Complete loss of speech

Swallowing difficulty

• Infrequent choking and coughing after drinking liquids

• More frequent episodes of choking and coughing

• Inability to swallow tablets

• Inability to swallow tablets

• Inability to swallow solid food, food needs to mashed up

• Inability to swallow

• Considerable aspiration

• Continuous drooling of saliva

Breathing difficulty

• Heavy breathing physical activity

• Feeling out of breath upon walking or climbing stairs

• Feeling out of breath while eating, bathing and activities of daily living

• Feeling out of breath upon lying in bed flat

• Inability to breathe while talking for a longtime

• Using neck muscles excessively while breathing

• Inability to breathe without external device support

Drooling

• Minimal drooling at night time

• Drooling in posture with neck in flexion

• General feeling of excess saliva in mouth

• Considerable drooling throughout the day

• Spitting of saliva while speaking and difficulty to swallow the excess saliva

• Sticky, thick saliva

• Inability to swallow the saliva

• Continuous drooling

Facial muscle weakness

• Twitching in the cheeks and chin

• Spilling of water while gargling due to inability

• Difficulty in opening the mouth

• Affected facial expression

• Facial asymmetry

• Minimal opening of the mouth

Neck muscle weakness

• Mild fasciculations in the neck region

• Difficulty to lift the head up from supine

• Difficulty holding the neck in the upright position

• Difficulty lifting the head up after flexing the neck

• Inability to look up in sitting position

• Severe neck cramps

Fasciculations

• Uncontrolled, sudden twitching of muscles

• Increased frequency of twitching

• Twitching of muscle in more

• Reduced frequency of twitching in the body parts that have undergone