Sarah,
I have never in my life , heard of anyone told they "may" have ALS with a "normal" physical exam and told that an MRI could suggest the possibilty of it.
I'll take that back , this poor guy once was told by a GP that because his tongue was scalloped , he may have ALS.It took him years of ALS specialists telling him he did not have it to believe it.
Even if this physician was a neurologist , which I am not certain of ?
He was not an ALS specialist ,as no way , would I believe an ALS specialist would even suggest the possibilty without extensive testing including EMG's.
ALS is a diagnosis of exclusion. A MRI can not diagnos ALS .
My husband was diagnosed with bulbar ALS - his MRI was normal. The MRI was used to rule out MS, Stroke etc.
If Becky has no symptoms , I would not worry. And I would again see an ALS specialist, if I was concerned immediately .
Migranes certainly are not a symptom of ALS
Lisa