Your EMG wasn't clean. You had a large MUP. You need to get another EMG in the same muscle and numerous other muscles. If no other large MUPs appear or any polyphasic MUPs, fibs, psw or anything else, you can be more certain it is not ALS, especially since you now have weakness (burning and fatigue).
The neurologists' stock answer when you have large MUPs without spontaneous activity is that you don't have ALS and it is a radiculopathy. It is the stupidest of all the stupid things neuros say. For example, you could have large MUPs with no spontaneouse activity and still have ALS because the collateral sprouting is keeping up with the rate of horn cell death.
I had clean EMGs at two and four months, and then, at six months, one that showed large MUPs in the muscles previously tested. Dr. said mulitple radiculopathies because no spontaneous activity. Of course that made no sense because I hadn't remembered getting hit by a bus or falling out of a fifth floor window in the past two months. So I had another EMG that showed large MUPs, polyphasic MUPs, and a fibrillation.
The point is, you need to do your homework and use common sense because the neuros certainly aren't doing so. When it comes to determining MS or ALS, the only purpose of a neuro is to order tests for you, because you can't order them yourself. Not to interpret them, just to order them. You need to do the interpreting and make a decision from there. In your case, I would get another EMG.
