Tongue Twitching

[knoxcurious]

A few days ago I noticed the tip of my tongue was twitching, almost in a pulsating like manner. My first concern was ALS as my biological father died of the disease, but given I am only 30 and Bulbar ALS is in and of itself rare I'm kind of skeptical about that.  I'm not having problems swallowing or talking and my tongue isn't "scalloped" or showing signs of atrophy.  I guess I'm worried because I've read that tongue twitching is usually a sign of something, and I've got an appointment with a neurologist at the end of the month, but I guess I'm just looking to be reassured this isn't something bad.

[knoxcurious]

It's been over a week and no progression of symptoms that aren't anxiety releated.  The twitching isn't constant.  I looked at my diet and discovered Magnesium deficency wasn't out of the realm of possibilities, and it could be hypothyroidism.  I'm going to see a neurologist next week, but I still worry.  The biggest thing I'm confused about is whether or not twitching is the first sign or whether muscle weakness should come first, because I've seen conflicting information on that subject.  As far as family history, that's it, my biological father, he has six older siblings, the oldest in their 70's and none have come down with the disease, nor is there any record of any other family member ever having the disease either.  

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

As you are aware, tongue fasciculations (or twitches) can be a symptom of ALS, but it can also be a benign twitch. When fasciculations occur in the setting of associated symptoms such as progressive loss of sensation, tingling or numbness, weakness, trouble swallowing and other symptoms, the twitch should be evaluate more thoroughly and urgently. Given your family history of ALS, it would be worthwhile to have an evaluation if the twitch continues.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.