I was diagnosed with progressive bulbar palsy a couple of years ago, mainly due to severe swallowing problem with no gag reflex which resulted in an eosphageal/trachea seperation and a permanent tracheostomy due to chronic aspiration. At that time though my tongue, though weak and wasting, didn't move on it's own in any fashion. About three weeks ago I noticed my tongue began to move back and forth in a subtle manner. This movement is becoming more frequent. I was under the impression, from all that I had read about ALS and PBP that fasiculations occurred before weakness of muscles and found no mention as to when this can occur As it figures, my next neuro appointment isn't till April and I am unable to obtain a better understanding through reading the medical material on the web as the word fasciculations are mentioned along with weakness but there is no clarification as to which comes first. I assumed fasciculations, if they happened, would come before the weakness. Does anyone know of PBP with tongue fasciculations developing late in the course?
Are fasciulations of the tongue always constant or does it come and go?

Any information is appreciated,

Thank you