Karin, Jim has bulbar onset, with limb involvement. We did also see Dr. Graves. Dr. Graves trained Dr. Abi. Jim has acute denervation, brisk reflexes, an elevated palate, fasiculations, loss of strength and loss of mobility. His emg was clear that it wasn't CIDP, or any other treatable neurological disorder. We have seen 3 neuros, one here in Thousand Oaks, Dr. Abi, and Dr. Graves. They all say it is 100% ALS.