Tongue fasciculation refers to fine, involuntary twitching movements of the tongue muscles, often described as a rippling or worm-like motion. It typically indicates lower motor neuron dysfunction, particularly involving the hypoglossal nerve (cranial nerve XII). In children, examination involves observing the tongue at rest and during minimal activity, ideally when the child is calm or feeding. A tongue depressor and good lighting may help visualize the movements. Common pediatric causes includ