tongue twitching

Hi I'm a 35 year old male and my journey with fasiculations started in late January of 2010.  I was told I have BFS and even had all the diagnostics and an EMG that was normal.  The fasics are all over and sporadic.  I was quite comfortable with my diagnosis until I noticed my tongue was fasiculating as well.  They happen anywhere from every other second to once every 30 seconds to a minute when I'm watching for them.  I also think that my tongue has a bigger dent on the right side whether its always been that way or not I cant say.  Its only when I jut it out though looks fine at rest. I have no speech problems although I have stumbled a few words and percieve myself as having difficult swollows occasionally then again I am very watchful and anxious about the whole thing.  I guess my question is if these were due to an MND would I have pronounced speech and swollowing problems or would they be intermittent.  And would these fasiculations be more constant if it were a MND.  I have a follow up EMG for piece of mind but just wanted to know your thoughts.

[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.

ALS is a progressive disease meaning it continues to worsen. There may be associated bulbar findings (i.e., difficulties speaking or swallowing) in ALS but there may be other findings. ALS is predominantly a clinical diagnosis with defined criteria.

A repeat EMG may be indicated if you have new symptoms or progressing symptoms.

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