I have been twitching for over 3 years now after covid and same with my fiance.. we are both under 35...

However it undoubtedly looks like MND for me.. The first 2 years were mostly fine, just muscle fatigue, tongue with fatigue a bit when eating large meals.. Arm would get tired a bit faster.. but at roughly 2.5-3 years in my voice got hoarse and quieter, drinking water would make me clear throat.

I am now diagnosed with double vocal cord atrophy, and i have a deviated uvula. Strange for Bulbar ALS to progress this slowly, but I am having undeniable and clinical atrophy at this point, i also feel weakness in my pinky and ring, while still functional it is undeniably a bit weaker.

Ofcourse classic ALS would leave me rendered full disabled by now, however I have seen many cases of younger cases progressing slowly (over the course of 10-20 years). While rare, it happens. No 2 cases are the same.

My fiance who is even younger than I, also has tremors, her muscles shake doing normal tasks. She has definitely "progressed" less than me, thankfully. Not sure why, only thing she does different is take nicotine, so maybe I will try that - but could also be random/genetic.

I can also feel my diaphragm weakening, on pulmonary tests I am not able to exhale fully, and i have had breathing issues which I suspect is a combo of my vocal cord issues on top of my diaphragm issues. I have also developed a heart arrythmia.

Before my infection I had 0 issues, now I have pulmonary,cardiac, and the worst of all neurological issues that point toward something terminal.