Clean EMG's but progressive issues for 18 months

OK- I have a question that none of my neuro's really give me a real good anwser on.  I have had ongoing issues for 18 months- here is the description-

18 months ago- Lower back pain, fatigue, twitching in left eye, noticed tongue has notches or teeth indents along sides
12 months ago- worse fatigue, twitching spread to whole body, neck and back hurt (muscles right along spine), pain under jaw (tongue muscles), sharp pain and soreness in back.  Back is very stiff in morning.  Legs also feel stiff.
10 months ago- Voice gets horse, extreme exercise intolerance (very sore if I exert my muscles), all of the above issues continue
5 months ago- went to ENT because of contant "tickle" in my throat.  ENT dx me with vocal fold atrophy but has no opinion as to cause.  Also notes that my tongue is "quivering" around edges and that could be indicative of weakness.
2 months ago- Hands seem to have a tremor when I raise my wrist.  It is a small tremor that ossilates and gets bigger after 30 seconds.  Weakness?
3 weeks ago- noticed my right hand on the palm (pinky finger side) looks deflated and has some strange grooves forming.

I have been to 2 neuromusclular specialists.  I had an EMG done in Dec at OSU- clean, had EMG done in Jan at Clevland Clinic-clean, had another EMG done at OSU in June (included tongue, paraspinal, and right hand) showed fasics but considered normal.  I have had MRI, blood workup, ect- all pretty much normal.

My question is this- If I have had twitching for this many months and it was due to ALS would it for sure show up in my most recent EMG? Next question- How could I have atrophy in my hand and the EMG not pick it up (I cant get a good anwser from anyone on this)?

If this is bulbar, would it show up on EMG by now and would I have trouble talking and swallowing.  As of now, I dont have swallowing or talking issues except my tongue muscle under my chin will get sore if I talk alot? I have not had a muscel biopsy yet, would this show ALS?  I think I am going to wait until Oct to have this done(my nuro already said it is an option)?

Thanks- CB1977













































Thanks- CRB1977

[CRB1977]

I forgot to mention that I am 32 years old.

[skimarie21]

Hi there! I'm a dental hygienist, and I wanted to lend a little help by giving you feedback on one of your questions... bi-lateral corrugations on the tongue indicate a condition called  bruxism, which is the clenching and grinding of the teeth. As a result of bruxism, a person usually experiences twitches, as well as spasms in the jaw due to over-exertion.Good luck in your endeavers.  Don't give up!