Biting cheeks, twitching

[felicity1987]

Hi,
Twitching started 1.5 yr ago, mostly with my left eyelid (it is still constant). Then It became widespread (legs, arms). Now I am concerned because the last month it has been frequently around my mouth (upper, lower lip).
From January 2024 I sometimes have a feeling I have a lot of saliva and I have to swallow often. For the last 2 weeks I have been biting my cheeks on multiple occasions while eating and speaking.

In March 2024 I went to neurologist and had emng of my arms and also a brain mri. Everything fine.

I am terrified because of cheek biting and twitching around my mouth. I am now eating very slowly to avoid that.

Would the emng of the arms register muschle atrophy if I have bulbar onset? Would I have more symptoms If biting is because of ALS? How can I be sure if cheek biting is not due to als? I can smile, talk, drink, I dont feel weakness. Also my creatinine levels are fine (I read that creatinine levels can be low foe some time preceding the diagnosis).

I am 36 yrs old.

Thank you in advance!

Just to add, I also sometimes have a feeling of slight tingling in my left chin (last month or so).

I know that ALS is not a feeling (altough I have read it can be a sign of muscle wasting), I know that it is very rare at my age...but still....

Would muscle atrophy be visible by now with clinical examination? I have read from some of the members how their first symptoms were cheek, lip or tongue biting. Is this very rare for bulbar onset (to start with biting)?

Thank you for everything you are doing here. I pray for all the people affected with this disease.

 

[lgelb]

Many of us bite our inner cheek and have twitching, often worse when tired or eating in a hurry. If you grind your teeth in sleep, you can ask your dentist about a bite guard to use at night that might help keep your teeth away from your cheek.

You ask how you can be sure this isn't ALS? An EMG and a neurologist say it isn't so, which is an excellent conclusion. But many of the things you speak of are made worse by feeling anxious, so if you can't deal with these fears on your own, there is no shame in seeking counseling.

 

[felicity1987]

Thank you! So what you are saying is, if EMG of arms was normal, it would rule out ALS in general (including bulbar)?

 

[lgelb]

Yes. The hallmark of an EMG that supports ALS is certain abnormal findings even in muscles you don't have a problem with.