Possible ALS diagnosis now by neuromuscular Dr. Started year and a half ago with left leg now to right leg cramping , twitching muscles, tight painful muscles. All mimics ruled out by way of every scan ,blood test, muscle biopsy. Have had 3 emg's. Hyperreflexia, positive bilateral Hoffman's, painful tight muscles, cramping, twitching. I could go on but my ? Is why does the doctor say let's see how you progress .