Just had my first EMG about 2 weeks ago, after 4 months of twitching. My twitching started in both legs, now it's spread to my trunk, back, arms, and face. I don't twitch incessantly, but it's usually always going on sonewhere. However, the morning I went for the test - no fasciculations showed up on the EMG. The doc only had the needles inserted for a few seconds apiece, just long enough for me to flex the muscles. So unless I was constantly twitching at a high rate I doubt any would have been picked up. He did my left leg, right arm, paraspinal muscles from lumbar to cervical and my neck. He didn't stick my tongue, but I understand that bulbar ALS typically shows EMG changes in the neck and cervical paraspinal muscles. The EMG test is not pleasant, it is uncomfortable especially if you don't like getting stuck with needles. The NCV test felt like I stuck my finger in a light socket. Jim