Does a twitching tongue have you fearing you might have bulbar onset ALS?

When a person initially becomes aware of tongue twitching, he or she normally has no idea what bulbar onset ALS even is.

The problem arises when the person does an Internet search on tongue twitching, and links to ALS sites come up in the search results.

The individual immediately sees, upon scanning the search results, that a twitching tongue can be a sign of bulbar onset ALS.

Another way this is discovered is when the individual is already aware of muscle twitching being a symptom of ALS, due to having done an Internet search on twitching muscles one day — and seeing ALS links come up in the search results.

They fixate on possibly having this neurological disease, learning about bulbar onset along the way.

Then one day they notice a twitch in their tongue, and so begins a fixation on the bulbar onset version.

If you’ve clicked on this article, then you already know that this motor neuron disease is an incurable, fatal affliction in which muscle twitching is a symptom.

The tongue is a muscle, and, like any other muscle in the body, it can be prone to twitching for benign reasons.

Bulbar onset ALS is an extremely rare condition, afflicting about 10 percent of ALS victims, and this motor neuron disease overall is a rare disease, with about 5,600 cases diagnosed yearly in the U.S. What’s 10 percent of that?

Only about 600 people per year in America are diagnosed with bulbar onset.

If you’ve noticed a twitching tongue lately, it would be quite irrational to jump to the conclusion you might have bulbar onset ALS.

Remember, the tongue is a muscle, and muscles, by nature, are prone to twitching for benign reasons such as fatigue, stress, dehydration and mineral imbalance.

There is far more to bulbar onset ALS than the twitching tongue.

“ALS with bulbar onset is unusual but presents with subtle speech changes and difficulty controlling chewing/swallowing of various consistencies of food,” says Kristina Lafaye, MD, board certified neurologist and full time clinical staff and director of the neurophysiology lab at Ochsner Medical Center.

Dr. Lafaye continues, “This is also a gradual process. There is coughing which may prompt consideration of a respiratory condition such as asthma or COPD.

“Unless an individual is having the aforementioned symptoms, then they do not have bulbar onset ALS.”

In short, if you’ve developed the habit of persistently examining your tongue in a mirror, you are wasting valuable time if your only symptom is twitching.

You may be perceiving difficulties chewing and swallowing food, but there is a huge difference between perception and performance.

If the food is getting chewed in a reasonable amount of time, and swallowed without gagging and choking, then you do not have bulbar onset ALS.

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.