Becky ,
I am glad you are going to see an ALS specialist.As this would be the most qualified person to rule ALS out or diagnos the disease..

What confuses me and absolutely biogles my mind is if most ALS Mri's are normal in ALS - what does consistent findings for ALS on a Mri mean ? What significance in diagnosing the disease itself could they have.
To me that just does not make sense - as if most Mri's of people with ALS are normal , how could it be a indication of ALS in someone who was completely asymptomatic of the disease ?
My husband was told his Mri was normal --it was only ordered to rule out other possibilities Ms , brain tumor -- --that may have caused his slurred speech , clonus hyper reflexes , exaggerated gag reflex that were seen in the clinical exam-

If you have a completely normal physical exam as you have posted - with absolutely no hyper reflexes , clonus , exaggerated gag reflex , atrophy , etc, -- I 'm puzzled why your physician would even mention ALS --


I understand the Mri - was done for migranes to rule out other causes for headaches -- but both migranes and headaches are not a symptom of ALS at all -

If the doctor did find abnormal findings on a physical exam consistent with ALS , that he neglected to mention -- I too wonder why an EMG was not ordered or an immediate referral was not made by him to an ALS clinic for further evaluation--

ALS is a disease if exclusion when no other explanation can be found to explain upper and motor neuron damage seen in a physical exam - it unfortunately can not be ruled out nor diagnosed first - as other diseases and conditions must be ruled out to explain physical symptoms and abnormal physical findings in a clinical exam-- this is true in saying the disease is even "clinically possible" as I posted on the accepted clinical diagnostic criteria on the link above.

I lost my compusure , in my first post , and should not have called the physician a jerk, but when you posted all he could think of was ALS after seeing your Mrii , for a migrane no less --I just did not and do not understand how that is possible --as ALS can mimic a wide variety of more treatable conditions -- migranes are not a symptom of the disease --and Mri's in most people with ALS are normal -- coupled with the fact you posted ie said your physical exam as well was normal --it just does not make sense to me of why he would even mention ALS.
Why scare you by even mentioning something like ALS --with no evidence to support the clinical possibilty of it --
Lisa