I've done a ton of rearch and read the BFS article and also read the "BFS In A Nutshell" posting....
My opinion...there are exceptions to both, making them both ...."inaccurate". LTR, you hit the nail on the head, this is changing, hitting younger people...It's casued by something attacking motor neurons....and...well....we' don't know alot about the brain, which is why noone can figure out this darn disease.
This brings me to my next point..since we know so little about the brain...except what parts do what and when it bleeds and swells...otherwise...that's about it, we know little about what to do when it goes south...hence...we know little about the course it takes south.....there are several courses. All the interestates look the same, but there are diffferent routes.....I.E.....increased reflexes are standard, weakness and atrophy, but it's not a to rule in or out, only a diag. tool of which route were headed down.
So, in a nutshell, i would say....you can have ALS with only one symptom..say...twitches..but...if, in a reasonable period of time (i've heard 3 months, give it 5)....you don't have any of the other symptoms....your more than likely benign. I haven't spoken to anyone that has twitched more than 5 months and didn't show other signs. This is supported by the Mayo Clinic research into twitchers who twitchhed for more than two years with no other symptoms....NONE of them develolped ALS.
ALS is progressive, fast and destructive...if you have it and the sypmtoms of it (ALS), trust me...you will know something is not right. You will feel like crap, have horrible muscle issues and well...be 1/2 way crippled (sorry to be so blunt) in some way shape or form in a few months. Oh YEH, and i've chatted with one PAL....it all started in his shoudler....lost his shoulder muscle..took 3 years to diag, 15 doctors......you know what the signs were for the first year.....LOSS of STAMINA........He taught me one thing.....Loss of STAMINA is in a nutshell....WEAKNESS.....yes...that freaked me out becuase, i've lost stamina..
Can you hold your phone for long without your hand cramping....can you lift the same weight 20 times like you used to or is it now only 10, but still the same weigh.....2 + 2 = 4......so if you can lift 10 lbs 20 times two months ago and 10 lbs only 5 times now....that's 2 + 1.....= well 3.....
So, if you've been twitching for a while..and your not loosing muscles (YOU WOULD NOTICE) and / or you don't have weakness...your about 99.9999999% clear and congrats to you.
Now that i've scared 1/2 of you and made the other 1/2 feelmuch better, i've gotta get back to work here....best to all.
Good luck to all
rgds,
Jamie