Symptoms started in Feb. Weakness in left arm and leg and extreme fatigue. Has grown progressively worse. Saw neuro at teaching facility. Positive Babinski on left side and hypertendon reflex on left side. Muscle atrophy in left hand - left calf muscles measures 2 inches smaller than right (done by neuro). Loss of muscle mass in left arm as well. 2 weeks ago weakness spread to right side as well. This week severe cramping in hands and feet - fingers get "tired" typing, but still functioning. All along have had twitching all over body - this week for the first time is in my face too. Just recently started feeling like I am hoarse and some difficulty swallowing. Normal MRI of brain and cervical spine in March. Had EMG in Feb, normal and EMG by teaching facility 2 weeks ago on entire left side and he said normal. Said "you don't have ALS now, I can't say you won't have it in 2 years, but you don't have it now". Negative test for Lyme, bloodwork normal, at low range of B-12, started injections 6 wks ago, no change in symptoms. Now has ordered an MRI of thoracic spine. He said not to worry, but the symptoms are progressing. I am a 32-year old female and was very active up until this January when I was overcome with fatigue and then symptoms developed. Does the EMG rule out ALS? What else could cause these symptoms? What other tests should be ordered? Next step? Any advice appreciated. I am very scared.