Ottawa girl gave you wonderful advice that you should keep in your mind and repeat every time you worry about als. Do not worry about twitching either. Everyone twitches. I'm 38 years old and started twitching in my left arm 4 months ago. 2 days after it started the twitching spread to my entire body. I have literally twitched everywhere, with the exception of my teeth. And I still twitch to this day. It's the first thing that happens when I open my eyes in the morning. Like you, I also worried about als at first. In fact, I became so sick over the thought that I had it that I could barely function during the day. I was an emotional wreck. I now know I do not have als. I rarely come on this forum anymore and you should avoid it also as it will only feed your fears. I found out from my neurotologist that my twitching is related to an inner ear condition I have called Superior Canal Dehiscence Syndrome. It's where the person is missing part of the temporal bone near the brain. This condition has completely thrown my body off and caused odd symptoms because of the stress. My point is, there are so many reasons people twitch. And most of the time, people twitch for no reason at all. You are 20. It is practically unheard of for someone your age to develop als. Spend your time online looking up funny YouTube videos or going out with friends, things a 20 year old would enjoy, not searching for symptoms online.