Thank you for posting your query in detail at DoctorSpring.
I am a qualified Neurologist and have experience of about 15 years in treating neurological disorders, and would have seen about 500 cases of ALS so far in that period.
First of all, I would like to reassure you that based on your description, my diagnosis would be BFS, and not ALS.
Also, vitamin D toxicity does not usually lead to fasciculations.
Patients with ALS usually present with weakness and/or wasting of muscles and these symptoms tend to progress over time. Within six months, there is definite worsening. Symptoms begin in one limb and then progress to other limbs over 2-3 years. It does not start in whole body at a time.
I agree with you that EMG is not definitive, in the absence of typical clinical symptoms, and also it would need to be repeated. So, I also would follow up a patient clinically rather that do an EMG if some one came to me with symptoms such as yours. The only time I would do an EMG is if the patient requested me to do in order to be more sure that it is not ALS.
I hope it helps. I would be pleased to answer any follow up queries.
Dr. Sudhir Kumar MD (Medicine), DM (Neurology)
Senior Consultant Neurologist, Institute of Neurosciences,