Keep in perspective, that study about the "6.7% of cases present with fascics alone" was misleading and not one of the patients had an EMG at that point, which if facics caused by ALS were present, there is NO WAY that an EMG would have missed it, if it was performed correctly.
Facisc caused by ALS are a SECONDARY condition CAUSED by dying muscles and nerves, NOT the other way around. Fasics do NOT "cause" ALS what so ever, and again, if they are present because of ALS, weakness or not, the EMG WILL pick it up.
That "6.7%" test was VERY misleading and out of context. It meant that 6.7% of the peopel "noticed" fasics first. Well, if ALS starts in a large muscle group, it may take some time for it to render that muscle useless, and for weakness to show-up, but if it's in a hand or a finger or a foot, it certainly will NOT take very long for weakness to set in because the muscle size and density is much less, which in turn, means that it will take much less time for effects to happen in smaller muscles.
ALS is not a mystery disease, it has boundaries and borders and it is really a quite simple disease with devestating effects. There are also rules with it and one of them is that fasics with ALS are secondary. There are no if's, and's or but's about it. If you are worried and can't wait a span of time to see what happens, then get an EMG and if you had ALS with twitches, that would mean it has already taken hold and would not be missed if the EMG was performed and read correctly. It's pretty much as simple as that.
About the waiting up to 13.4 months deal... that is another statistic taken out of context. ANY disease has grey areas along with black and white areas. Things can get misdiagnosed, tests mis read or misperformed and so on. There are also lots of quack doctors out there that just don't pay attention and so far, that 13.4 months thing was ONE person! Out of all of the worlwide cases of ALS, which are VERY small numbers compared to just about ANYTHING else, one person had the misfortune of finding out 13.4 months later that someone along the line (incompetent doctors) were not paying attention.
ALS is real, if it is in your body, doing it's thing and you have fasiculations CAUSED by ALS, a GOOD doctor who knows how to perform an EMG CORRECTLY and read it CORRECTLY could certainly find-out what is going-on and it certainly wouldn't take 13.4 months to figure that out.
You know, some people die of cancer in a short amount of time and other's life for decades after a bad bout of cancer. It is all in how and when it is diagnosed and treated. I'm not saying that ALS can be treated, because so far, it can't be with any effectiveness. What I am saying is that even with something as common as cancer, where 1 in 3 of us will most likely get it in some form or another, there are strange scanarios and there are black and white scenarios. It just depends of the patients awareness of their own body, the skill and experience of the doctors and finding it in time to do something about it. ALS is exactly the same way EXCEPT for the ability to do something about it part.
How many people do you know that had a cough and the doctor said it was just a smoker's hack and later-on that person ended-up with serious lung cancer? I know several friends that have had this happen with lung and throat cancer, where doctors just blew it off as nothing. They'd call it "smoker's hack" or "wiskey voice" and two friends of mine recently died because of two different doctor's lack of concern, lack of knowledge and inability to do their job.
So, what does this have to do with ALS?, well everything! If this cancer misdiagnosis stuff happens so commonly with people we know personally, then why would it be a mystery that one or two doctors out there could misdiagnose or blow-off something as rare and as serious as ALS, such as in that 13.4 months before being diagnosed or the so called 6.7% presenting with fasics alone?? Of course there are going to be scenarios like that, but it isn't because of an ALS mystery, it is because of mistesting or incompetent doctors and like I said before, not one person in that 6.7% study had an EMG at that point. That's a pretty crappy statistic then, isn't it!
So, quit overanalyzing these out of context statistics and move-on! See a GOOD neuro with experience and get an EMG if you have any doubts. It's pretty much as simple as that...
). There's an awful lot of discussion about 'weakness' within the forums but I can't seem to find much on at what stage the weakness becomes apparent. Most days i wake up thinking 'will this be the day that I can't pick that cup of coffee up?' Just wondered when i might be able to rid myself of this one. Do you have to reach a threshold of time before it's improbable that the weakness/atrophy will manifest itself?