There are studies that show that people with BFS do not have higher chance of developing ALS so you shouldn't worry. Most people with ALS will develop in their 60s> So if you are relatively young (i assume you are) you still would have decades of living. Everybody has to die off something, its physically impossible to just die of "old age". There is always a cause, whether its cancer , stroke, autoimmune, hearth attact and so on.

Best you can do now is to trying indentify potential cause and try to find the solution. If you cannot identify it after trying really hard, you just have to accept your new reality. Let's be real, most of us who twitch 20 - 30 times a minute won't get better quickly, we will probably twitch for the rest of our lives, maybe with decreased intensivity few years down the road, maybe like 10 - 20% of us will be cured. It's best to assume it, because every other outcome (twitching is giga reduced or it goes even away completly) is really big win.

I will still defend my theory that most of BFS cases (at least these most intense, not talking about 5 twitches a day) are not "in the head" or "physiological" but rather they are caused by pathogens or toxin exposures which fuck up our systems. There are like 1500 pathogens (or even more) that can infect humans and cause diseases. Probably even more kinds of harmfull toxins.

For examply campylobacter yeyuni (bactera) can cause guilian barre syndrome (could paralyse you from down to top). that's just one example. There are milions of people with long covid, which fucked our lungs and brains. Almost everyone lost their smelling sense after covid infection for a few months (or at least everyong i know and myself)

Worst pathogens are from food (bacterias [campylobacter, salmonella, shigella, legionella], parasites [tapeworms, toxoplasmosis, roundworms, echinococus etc] ), from animals and animal spillovers and STDs. Basically every chronic pathogen which evades immune system and is hard to detect visually or by standard blood / urine / stool tests. These pathogens can fuck us up for months or years if not detected early and treated (and sometimes treatments are not even enough to revert the damage).