Neuromuscular Problems...help with next steps

[FootballNick]

I'm 43 (M) in good health (overweight).  3 months ago my hands started cramping and becoming stiff when golfing and for menial tasks. Left hand more frequently - graduated to my right hand soon after.  The symptoms worsened, hands constantly heavy. Infrequent numbness in my hands/arms during sleep   Loss of dexterity when writing more difficult to type.  Miss keys and make errors when typing.  Dull pain in wrists and metacarpal with flex and sluggish fatigue in hands and wrists.

Past 3 weeks new symptoms in biceps/triceps (both arms).  Constant muscle fatigue (worse in AM/PM). Less flexibility, intermittent numbness and tingling in the left wrist/hand and infrequent burning both wrists/hands.   No fasciculations.

Dr visits:

Inital  Blood work showed slightly elevated Sugar and Inflammation only a couple of points above the normal threshold - Lyme was negative.

Neurologist exam came back OK for reflexes,  strength, balance/coordination, hot/cold, tongue, pin stick in various places.  Unable to Dx any problems...potentially "peripheral" nerve damage.  No other signs for a neuro-motor disease such as ALS or other. No fasiculations.

NCV / EMG on left hand/forearm/elbow:  No signs of nerve/muscle damage.  Slight Nerve delay in left elbow area compared to right.  No indication of ALS nor carpal tunnel. Symptoms have since worsened especially the muscle fatigue in both biceps/triceps & loss of arm/hand flex.

Symptom Summary:

HANDS - dull metacarpus pain when flexing wrists, numbness when still, dull finger pain (all hand symp. higher degree in left)
ARMS - forearm tightness,  fatigue/cramps in biceps/triceps when performing menial tasks
SHOULDERS/NECK - dull pain when flexing, stiffness
LEGS - cramps in calves,  stiffness when still
FEET - stiffness when idle too long, infrequent numbness

Follow-up with the Neurologist in January and have a script for an MRI (head).  Any recommendation on what else to do / look out for would be appreciated

[FootballNick]

Further Update:

I've begun to notice fasciculations in my left arm near the Tricep area. This is the same general region that I have been experiencing muscle fatigue.  They started intermittently but seem to have increased regularity at this point but in the same spot.  I'm not sure how long this has been going on, but it must be recent.  I've read in the forum that a Fasciculations generally appear well after ALS has set in.  As indicated I've already had an EMG on my left Hand / Wrist.  Should I be further concerned and ask for another EMG in the area of the twitching?  I seem to be weakening by the day now...and generally am starting to feel fatigued and tired overall.

[chicachopper]

A related discussion, pin point bilateral elbow pain was started.