I have had neuro symptoms of chronic muscle fatigue (weakness?) in my arms, thighs, legs, hands, twitching in different areas, and esophageal motility disorder, to name a few. I have a difficult time sustaining energy at the gym to work out. I have muscle atrophy in my left hand (dr has mentioned it), and facial asymmetry (left cheek is sunken in). My ankles have thinned so much that I have to buy sneakers that have the extra top hole and wear thick socks, to keep the shoes on tight enough. I have had several EMG's since 2002, the latest being in January 2006 by a Physiatrist. She tested my tongue, thoracic paraspinals, the atrophied area in my hand (hand a little bit of a hard time getting the area to activate, but, it was ok, I guess), a couple of spots in the back of my shoulder, by my hip, inner knee, calf, and foot. She said it was normal. The physiatrist is stumped because she can see the asymmetries I am speaking of, but, doesn't have any answers. At this point in time, do you think I can safely rule out MND? Any ideas of what might be going on? Myasthenia Gravis, or some type of muscular dystrophy? Thank you for your expert input.