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Around 30% of patients start with bulbar symptoms, which affect the muscles used for speaking and swallowing, leading to problems like slurred speech (dysarthria), trouble swallowing (dysphagia), and twitching of the tongue muscles ( The disease usually begins in one part of the body and spreads gradually, leading to increasing muscle weakness

[DOI] [PMC free article] [PubMed] [Google Scholar] 2.Rizwana N., Agarwal V., Nune M

Slow-growing : They tend to grow slowly and are often found incidentally during pelvic exams or imaging