A neurologist explains why constantly examining your tongue for Bulbar ALS doesn’t make sense.

Your tongue is twitching, you Googled twitching tongue, and now you’re terrified you might have bulbar onset ALS, because the bulbar onset version of this awful disease can involve a twitching tongue.

You’ve been giving your tongue all sorts of strength tests, such as quickly moving it back and forth, pressing it against the roof of your mouth and so on.

Being that ALS references show up on the first page of keyword search results of tongue twitching, it’s no wonder that you’re now freaking that you might have ALS.

It certainly doesn’t help that the second page has several more ALS links regarding tongue twitching.

Ironically, the first two pages of the search results also reference nonfatal causes of tongue twitching.

But it’s human nature to fixate on the worst possible explanation, even though bulbar onset ALS, whose symptoms indeed can include tongue twitching, strikes about 1,375 Americans every year. This makes bulbar onset ALS an extremely rare disease.

However, the fact that it shows up amply in search results for tongue twitching creates the illusion that it’s more common.

“If a person is really worried about having bulbar onset ALS,” says Kristina Lafaye, MD, “inspecting the tongue is not the exam to perform.”

She adds: “If they do not have any problems with swallowing, chewing, or controlling their secretions, then they do not need to bother looking at their tongues.”

Dr. Lafaye is a board certified neurologist and a full time clinical staff director of the neurophysiology lab at Ochsner Medical Center.

“Bulbar onset is marked by problems swallowing, chewing, and controlling secretions,” Dr. Lafaye points out.

“There is coughing and a perception of food (liquids) ‘going down the wrong way.'”

She emphasizes that development of these symptoms is “subtle” and not an overnight process.

Search engine results do not correlate with how common a disease is.

They only indicate how often it’s written about, and/or how crafty the keywording of the article is.

Effective search engine optimization and latent semantic indexing will help get an article at the top of the search results.

Don’t let that fool you into believing that your twitching tongue means you might have bulbar onset ALS.

The first two symptoms of bulbar onset ALS are speech and swallowing difficulties.

When scared people, who Googled tongue twitching, learn this fact, they feel relieved, but the relief is often short-lived, because soon, the person then starts perceiving difficulty speaking and swallowing.

Attention then turns to talking and swallowing. Nevertheless, the tongue continues to twitch, often more than ever, panicking the person.

Bulbar onset ALS progresses rapidly, but an anxiety-stricken person can remain terrified of bulbar onset ALS on a chronic basis, even though after months and months, the only symptom he or she has is the twitching tongue.

The person has “molded” their mind into thinking a certain way, and it’s virtually impossible to just snap out of it.

The best treatment for this hypochondria affliction is behavior modification, and visiting new perspectives.

Suppose you know that 1,375 Americans every year get zapped by aliens into thin air, but a year before this happens, the selected victims experience a normal headache.

Would this mean that every time you had a headache, you’d freak out and feel convinced that the aliens have you on their zap list?

Probably not, especially since you know that millions of people suffer headaches every day, and there are over 300 million people in this country.

You’d recognize the astronomically low odds that the aliens would ever zap you.

Yet, this same kind of thinking does not take place with people scared out of their wits that, due to a mere twitching tongue, that they probably have bulbar onset ALS.

Maybe it’s because a twitching tongue is a stranger symptom than a headache.

We grow up hearing about headaches. We hear about headaches all the time, everywhere. They are part of our culture, part of living, and part of our vernacular.

How often do parents tell their kids, “You’re giving me a headache!” Headaches are the topics of jokes and humor.

But tongue twitching? What is THAT? Seems mighty odd. But it shouldn’t be. After all, the tongue is a muscle.

And muscles twitch — millions of times in millions of people EVERY DAY. A twitching tongue shouldn’t frighten you any more than should a twitching calf muscle. The tongue is a muscle.

Nonfatal Causes of Tongue Fasciculations

–   Anxiety (which may initially be due to factors unrelated to health, such as money or relationships)

–   Fatigue

–   No known cause other than sometimes, muscles just twitch

–   Benign fasciculation syndrome (annoying muscle twitching disorder)

–   Side effects from some medications

–   Mineral imbalance, particularly calcium/magnesium deficiency

–   Dehydration

–   Dystonia (neurological movement disorder)

–   Bulbar onset ALS – but realize THIS: About four out of every 100,000 American people will be diagnosed with ALS. Bulbar onset comprises 25 percent of ALS victims.

This means that it would require up to 100,000 people before a new diagnosis of bulbar onset ALS was made.

You can’t live your life as though you are that one (or four) person out of 100,000.

You are over 30 times more likely to die in a car accident this year than get bulbar onset ALS.

So next time your tongue twitches, relax, take a few deep breaths, and promise yourself you will stop examining your tongue in the mirror.

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.  
Top image: Shutterstock/MCarper
Sources: nlm.nih.gov/medlineplus/ency/article/003296.htm   & cdc.gov/mmwr/preview/mmwrhtml/ss6307a1.htm