Hi Colleen,
My neurologist did say some do present with twitching first

scary...
The neighbor next door to me has a co-worker in his 30's that was diagnosed with ALS and his first symptom was falling to the ground(not tripping) while jogging, due to weakness.
My very first symptom was a left eye twitch(dec 02) for about 2 weeks, then my right eye started, soon my whole body was popping allover. The twitching has subsided to a lesser degree. I've been taking 2,000mcg's of vitamin b-12..maybe this is why. When I do twitch wildly it's
my calves and arches of my feet. I have lots of feet cramps, where my toes want to move to one side..HOW PAINFUL.
I still don't have muscle weakness either, and hope I never do.
I was shopping today and tripped over my feet twice, but maybe it's because of my BIG FEET
Did you ever have thyroid testing? People with thyroid problems sometimes have aching joints, although I don't with my hyperthyroidism.
Let's cross our fingers and hope are symptoms go away or at least not progress.
Renee