Thank you for answering my question. Because I was worried about it, I did have a neurologist check it out. He didn't think that it looked abnormal so they did perform a EMG where the tongue muscle connects to under my chin and it turned out ok. They also performed the EMG test on the back of my neck and my left arm as well as a nerve conduction study. They did this all because I had been having some consistent twitching, but since it all turned out ok, I figure it was just anxiety.
I was surprised how quickly they could decide that a muscle was "good" with the EMG. Is it generally that initially conclusive? They did it on my left hand, arm, back, neck and under jaw in less than 10mins. Is it easy to see when a muscle is even slightly affected with a ALS-like disorder with these tools?
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 your doctor.
Without the ability to examine you and obtain a history, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.
Some asymmetry in the tongue with mild deviation can occur and can be a normal finding. However, if there are associated symptoms such as difficulty with talking or swallowing, then a pathology should be ruled out. The location of the nerves to the tongue in and around the brain is near other nerves, so that if the nerve to the tongue (called the hypoglossal nerve) is affected by some process, other symptoms would be expected to be present, such as swallowing trouble. In general though, if there is subtle asymmetry of the tongue without associated symptoms, and if there is subtle tongue deviation, it is unlikely that there is some neurologic problem going on, it is most likely this is within the range of normal. However again I can not be sure if your tongue asymmetry/deviation is within the normal range or suggestive of an underlying process, and I do recommend you be examined by your regular doctor (family physician, internist) to make sure that there is no suspicion for a problem.
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.