PLS usually begins with lower-extremity stiffness and pain due to spasticity. With progression, which is a gradual process, people with PLS may develop balance problems and lower back and neck pain.
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In PLS, voluntary muscles (muscles that you can decide to move) are affected, which may include the muscles that control urination, whereas in ALS, involuntary muscles are affected, too. So, in addition to the muscles affected by PLS, ALS often affects the muscles that initiate breathing, which is why breathing problems in ALS are more severe.
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In PLS if an EMG that shows no evidence of chronic denervation which is the true trigger (cause) of fasciculation in an honest (confirmed) diagnosis of ALS If you have a diagnosis of PLS (or possible) and you talk to your Neurologist about fasciculation you will get, 99% of the time, get a vague answer.
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