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http://www.leagueoflegends-wiki.com/lol/champions/twitch---the-plague-rat/twitch---aka-john-rambo-the-rage-inducing-steamloller
The mastery setup I posted is what I use with teemo and was fiddling with that for twitch too. If you use the masteries I posted you can take exhaust and a second spell by choice or when you use suggested spells loose the point in cripple and further down you can opt to take improved rally.