question: Hello doctor, I am a 25-year-old female and I am afraid I have ALS. This started with twitching in my right calf muscle two months ago and that has now spread to everywhere. A clinical exam showed slightly asymmetrical brisk knee reflex, and it is brisker on the right leg where it bothers me, not including the plantar reflexes. Everything else was said to be fine. I had EMG that was normal except for single highly polyphasic motor units with a high amplitude which signal a nerve issue at L5-L4, but my MRI only showed scoliosis which I have had since a child. I am very scared. Please advice me. You think this may be an early onset of ALS?