Hello all, I am a new member who has been through testing and have been told by people who should know that I don't have als. And yet, I just have trouble accepting it because my symptoms are so suggestive of early limb onset als. My right thumb, esp the extensor pollicis brevis (on the meaty palm side) has been twitching constantly for 6 mos, fine twitching that is almost always there, the odd twitch elsewhere in the right hand, along with this light pain that isn't a cramp. This muscle is smaller a little than on my left hand and I am right handed and don't know why this reverse of the normal asymmetry should be so. The assessment at the well-known ALS clinic was about 2 and a half mos ago and nothing has really changed, other than a subjective feeling that the right forearm tires more easily. But clinical testing for weakness was normal as was the neuro exam in general. The EMG showed occ fasc. all over my right side, inc hand, arm, leg. , also the twitching thumb had one repetitve discharge which certainly scared me, but they thought it was of no significance. Nothing else on EMG, mild carpal tunnel bilat which I have no typical symptoms of. So it has been about 6 mos of twitching and a smaller muscle in the hand which happens to be the twitching one, which they aren't calling atrophy, but I don't know how long it's been that way, obviously for a while since it hasn't changed and no other hand muscles look smaller. I just keep checking and worrying, testing the strength, waiting for some kind of obvious sign that something really serious is going on. I mean, am I nuts or what? How long do you have to wait before you can blow it off on benign fasciculation-cramp syndrome which is what I have been told I have? Thanks for your patience.