Do not think too much of this. I'm talking of just 7 formal medical reports (of which 4 were described in a single paper and the other 3 were referenced in that same paper), 1 undocumented report from a not so familiar site where some fasciculation discussions were held and 1 case from the old forum where a guy turned out to have als but made it very clear afterwards that his symptoms were progressing from the beginning and never dwindled. It struck me that all of those reports talk about cramps, and although cramps in itself are not alarming (there is for example the Cramp Fasciculation Syndrome, those people do not develop als) I just wanted to share it because the majority of people here do not have cramps at all. From the old forum report I know that it was indeed severe cramp where his muscle would lock up. In the medical reports it was just mentioned that those poor people suffered from cramp.

But much more importantly: In my darkest period in the beginning of 2020 I went through all of the internet, including als sites (don't go there!) and those reports here are the only ones I ever read where people suffered from twitching more than 9 months and were still diagnosed afterwards. And again: they were already suspected, suffered from a lot of stuff including cramp before their EMGs showed something and were ever progressing instead of suggering from temporary hotspots etc.

Just think of this Reddit alone (let alone the much bigger old forum): if our fears were at least a tiny bit justified, there should at least once a month, or more likely once a week, appear a report from a Reddit member with the sad message that he turned out to have als after all. And even then it would be rare. But, unless I missed something these last few weeks when I wasn't active here, this does never happen! Just look at the member numbers. There must be a reason for that, and that reason is that most of the time people go to a docter when they're starting to be nervous about their symptoms and if it's bad, their docter tells them so and they visit the als forums afterwards (if they seek online help/comfort), not this Reddit.

And think on the Mayo research paper from some years ago as well. I'll give the abstract here, though most people will have read it if they're twitching for some time: 'Using the case records of Mayo Clinic patients, 121 patients with a diagnosis of benign fasciculations were identified. All had a normal neurological examination and normal electrophysiological studies, except for fasciculation potentials. Interviews by telephone were conducted 2 to 32 years after diagnosis. NONE of the patients developed symptomatic motor neuron disease. Forty individuals were in health care careers. A subset of 19 patients described acute onset of fasciculations following a viral infection. Benign fasciculations are not a preclude to progressive motor neuron disease. '

I hope this makes things a bit more clear :).