Is your twitching tongue keeping you up all night worrying you might have bulbar onset ALS?

Relax, relax. Don’t let a twitching tongue ruin your life. Do you realize how exceedingly rare bulbar onset ALS is?

Even if your tongue is twitching all over the place, don’t forget that your tongue is a muscle.

Muscles twitch.

That is a fact of nature.

Only about 600 people annually are diagnosed with bulbar onset ALS.

So the odds of your twitching tongue being a symptom of bulbar onset are over 60 times LESS than dying in a car accident!

Thus, examining your twitching tongue for every little distinction, every little groove, indent and twitching, in the name of “could this be bulbar onset ALS?” will prove nothing, really.

And don’t stick your tongue out to inspect for twitching, because the mere act of sticking out the tongue can cause this muscle to twitch!

And forget the side comparisons for size and shape.

“The tongue is a muscle, so like any other muscle one side could be a little larger,” says Kristina Lafaye, MD, board certified neurologist and full time clinical staff and director of the neurophysiology lab at Ochsner Medical Center.

Yes, one side could be bigger. Just like one calf or one foot or one bicep can be bigger than the other.

Focus on what your tongue can do, not what it looks like or whether or not it twitches.

Dr. Lafaye explains, “Basically, if the tongue moves normally as characterized by the person speaking, eating, swallowing, and breathing normally, then those are the important points.”

You need to learn how to distinguish between perceived difficulties chewing, swallowing and talking, and actual (or clinical) difficulties performing these functions.

Bulbar onset prevents carrying out these functions without true, actual difficulty.

The “rule of tongue” is this …

If you must concentrate and really focus your mind upon what you are testing for, then there’s no need to think bulbar onset ALS.

On the other hand, if you have bulbar onset ALS, you will not have to scrutinize and hunt for any noticeable problems, because they will be quite obvious.

Deliberately selecting tough-to-chew-and-swallow foods won’t prove anything.

Dr. Lafaye also says, “There can be atrophy of the tongue caused by other conditions (e.g., tumors compressing the hypoglossal nerve), but there would be other signs and symptoms as well.”

And that’s key: other signs and symptoms, and REAL signs and symptoms, not ones that you have to invent through carefully calculated examinations in order to keep your fear alive.

Dr. Lafaye is assistant professor of clinical neurology, and director, Neurology Student Education at Tulane University School of Medicine.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.