I saw my ENT yesterday, and he looked at my very dry nose and mouth and is ordering a lip biopsy to test for Sjogren's syndrome. The clincher was that I also cannot shed tears anymore. He may want to do the blood test again, too. By this time I've had enough blood drawn to provide a banquet for the whole Twilight gang! Can Sjogren's coexist with ALS? Sjogren's would not explain the tongue fasciculations to the right when I speak.