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Amyotrophic Lateral Sclerosis (ALS) Message Board

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First I noticed very fine twitches in my face whenever I smile
in the muscles around my mouth, cheeks, and eyes. (i can't feel them)
if I try to hold a smile, my mouth shakes/quivers.
At this time I also started getting pulsating twitches in my foot,
and random twitches throughout my body.
they've gone away for the most part and return occasionally

What worries me the most:
My tongue is twitching without me being aware of it.
I stuck it out one day and it was moving all over the place, it's like there are waves on it.
It also moves when it's at rest. This part really concerns me.
Lastly, I've noticed in the middle of my tongue, there's cracks developing,
there's a crack in the middle along with other tiny ones, it looks like a tree branch.
The underside of my tongue looks very shriveled up and wrinkly.

I haven't had speech problems, though I did bite my tongue a couple times.
My muscles are ok, even though they tire quickly, my arms burn whenever i have to raise them up above my head for more than a few seconds.
I can see the muscles in my hands and wrists. When I contract them, they stick out.. I can't tell if it could be a sign of atrophy or if it is due to me being underweight.

Also, I forgot to mention that I got botox done to the lower part of my face, and the twitching started around the time the botox wore off, could that have something to do with it? But it doesn't explain the tongue twitching.

It's been 2 months since I've noticed these symptoms, I feel ok, but the twitching scares me. Also i'm young, in my 20s.
Do you think it is likely I have bulbar, and if I do, would I have noticed it progressing in the past 2 months?
And can tongue fasciculations occur before speech/swallowing problems develop?

Thank you for taking the time to read this.

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