I'm no doctor but I do know a lot about ALS and I can say that ALS has a very 'classic' pattern that shows on EMG and for it to be ALS all of the pieces of the puzzle have to be there. Muscle twitching can be anything or nothing and is most likely nothing when it's all over your body. People with ALS twitch in the place they have weakness AFTER a muscle fiber goes limp and becomes useless. Twitching in ALS is the distress signal of muscles that have lost their connection to their motor neurons. So if you can flex a muscle that is twitching then that 100% means it's not ALS. Benign Fasciculation Syndrom or BFS is a long term disorder. A lot of people don't know that BFS often stays with you for a long time before stopping even years. What you have is most likely a combination of things and not ONE thing. Maybe is CFS? Also it's common to have light atrophy in a hand/arm affected by Carpal Tunnel.