This does not sound like ALS, especially given the fact that you are young, and have had a
normalNormal saline flush EMG. Have other systemic disorders such as lupus, connective tissue disease, or vasculitis been considered. I would have these investigated, and then consider a second opinion at a large academic neurology department. Good luck.
Any chance that you also had fatigue for months/years prior to this, and are also experiencing an usually high level of anxiety and insomnia in addition to your other symptoms?
Except for the symptoms I listed above, your symptoms sound a lot like mine. You might want to check out the article "The Importance of Magnesium to Human Nutrition" by Michael Schachter MD found at www.healthy.net.
If the article fits your situation, post again and I'll tell you more. I've been taking magnesium glycinate for about a month now, and it has taken care of so many of my symptoms including the swallowing problem, numbness/tingling, muscle aches/pains, feeling like I wasn't getting enough oxygen, plus stiffness in my fingers that I thought was arthritis. No more fatigue! I feel like I've gotten my life back. My twitching is almost gone--it's only occasional now and doesn't have the wild intensity it had when it first started and it kept me awake all night.
~snooze