Muscle twitching in people with ALS (Amyotrophic Lateral Sclerosis) can be very frequent. When muscles in ALS patients experience spasms, irritation, weakness, or fatigue, twitching is likely to occur. Muscle twitching in ALS patients is generally very frequent and is related to the disease. ALS, often referred to as motor neuron disease, is caused by degenerative changes in the central nervous system, such as the spinal cord and brain, leading to damage in the neuromuscular system, resulting in muscle atrophy, twitching, and tremors. It is advisable to seek medical evaluation and, once diagnosed, pursue active treatment which may include nutritional support, massage acupuncture, and functional exercise.