Does localized painless twitching in muscle areas like bicep, & tricep warrant a visit to a neurologist for emg? any benign issues or als?

Nonspecific: Most common cause of focal muscular twitching is benign, such as fatigue, overuse, lack of sleep, and even electrolyte imbalance or dehydration. ALS, on the other hand, is associated with muscle weakness and atrophy. If the latter occurs, this must be addressed.

No: Common with overuse, strain, stress, tension and anxiety as well as possible vitamin deficiencies. Not ALS.