Questions for neurologist: Hello, I've had a problem for the last 6-8 years or so which I've yet to get addressed. In 2013 I developed severe back pain from the top to the bottom of the spine. Spasms in back muscles only, and fasciculations, parasthesias and pain in both arms and both legs as well as pectorals and latissimus dorsi. Fasciculations also in sternocleidomastoid muscles, chin, eye and trapezius (i.e. cranial nerves). Parasthesias but not actual complete numbness. Also some parasthesias at the time in the genital region. I became almost bed bound for about 4 months, partially wheelchair bound for a year, and have partially but not fully recovered my strength since then. GBS was suggested at the time, but no spinal tap was done. My operative assumption at the time was that this was a back problem, however since then I've been told by a neurologist and two back specialists that my symptoms could not be caused by my back. Either they are mistaken, or there is some other cause. NCS/EMG in 2015 reads as follows: Brain MRI with contrast in 2017 showed nothing of note. Full spine MRI done in May 2015 showed some age appropriate degenerative changes, some dessicated disks, borderline central stenosis in the neck without touching the spinal cord, and mild foramila stenosis in a few places. Neck MRI with contrast in October 2016 showed: Straightening of cervical lordosis is present. No intramedullary signal abnormality, intradural mass or abnormal enhancement of the cervical cord is seen. Cerebellar tonsils are normally positioned. C2-3 uncovertebral spurring is seen without significant central stenosis of foraminal narrowing. C3-4 uncovertebral spurring is seen with mild left foraminal narrowing but not significant central stenosis. C4-5 uncovertebral spurring is seen with mild disk bulge. There is borderline central stenosis and mild bilateral foraminal narrowing. C5-6 Disk bulge and u-v spurring. Mild central stenosis, mild approaching moderate right and mild left foraminal narrowing. C6-7 Disc bulge and uncovertebral spurring are present. No significant central stenosis bit mild right greater than left foraminal narrowing. C7-T1 no significant findings. IMPRESSION: cervical spondylosis with mild central stenosis and mild approaching moderate foraminal narrowing as detailed above. Lumbar Xray in April 2017 showed: some foraminal stenosis L4-5 mild to moderate degenerative disk disease at same levels. Extension and flexion images of neck and lumbar region show no spondylolisthesis. A neurologist and two back specialists stated that in their opinion my symptoms could not be cause by the back. "Findings: Left peroneal nerve demonstrates an accessory peroneal nerve. The right response is a bit low amplitude, with lateral malleolus site not tested. Right radial response is normal. Electromyography shows now active denervations throughout. There is minor chronic denervation in the right tibialis anterior, mild to moderate in the left tensor fasciae latae. There is minor chronic denervation of the left biceps, a bit more in the brachiradialis, and moderately severe in the left FDI with decreased motor units. Upper more than lower cervical paraspinals on the left demonstrate chronic denervation changes – Conclusions: Essentially normal nerve conduction studies. Electromyography shows multilevel chronic radiculopathy upper and lower left cervical levels, as well as left L4-5, without active nerve root irritation”. Note: they only tested the left side of my body. My hands and forearms are weak and a mildly atrophied, the left worse than the right. Note: I do NOT seem to have the “split hand sign” as the thumb and pinky pads seem to be equally affected. Sensation is preserved everywhere to light touch and pinprick, except that light touch causes pain in the hands. Heelwalking on my left foot causes a mild foot drop. These areas are consistent with the findings on the EMG. I did have one doctor suggest thoracic outlet syndrome as I have diminished pulses and numbness when raising the arms above the head, as well as elongated transverse processes on my C7 vertebra. I also had another NCS show mild sensory carpal tunnel and my left hand does rest right on my ulnar nerve when I am working on computer which is about 5-6 hours per day. But this does not account for the overall weakness, failure to recover fully after 5 years, or the fasciculations, weakness and parasthesias in other parts of the body, or balance issues. Things seem to have a waxing and waning pattern, getting somewhat better for several months or half a year, and then getting worse. Reflexes in arms are diminished, reflexes in knees are absent. With the exception of my spine muscles, the muscles in the rest of my body are not spastic, but are instead kind of flaccid, especially in my arms. Babinski is negative. Hoffman is negative. Jaw reflex is normal. However during Romberg with closed eyes, I lose my balance within seconds. Romberg open eyes is better, but limited to about 20 seconds. I do feel generally unsteady standing still for more than a minute or two, but walking is better balancewise. Turning rapidly while walking is a bit problematic. I do have esophageal spams which cause difficultly swallowing sometimes, but at other times not. So technically I have difficulty swallowing, but since it is not constant I think this is a red herring. My tongue is normal size and does not seem to be atrophied. I have not been able to detect any abnormal movements in my tongue when looking at it in the mirror. My ability to stand is limited to about two twenty minute time periods during the day with many shorter walks to kitchen or bathroom. Total out of bed time is about 3-4 hours per day. Morning activity makes me profoundly fatigued and takes hours to recover from. Workups for Lupus and Rhuematoid arthritis were negative. Syphilis negative. Mysthenia blood work negative. B12 was a bit low/borderline in 2013, but I have been supplementing. Other B vitamins never tested. Vitamin E never tested. I have a history of alcoholism, sober since 2013, but in 2013 I went on high does of PPI (pantoprazole) and have been on them ever since, and in the last year PPI and raniditine. I'm wondering if some nutritional defiencies can be contributing? QUESTION: what is the differential diagnosis for the weakness, fasciculations, parasthesias? I need some avenues to pursue, since I've not gotten any real answers from my existing medical team. Total cholesterol is 140, LDH =90 and HDL = 30. These seems to be genetically low, since I have never taken any meds to get them like this. Testosterone is low. Problems: Morbid Obesity 330lbs, hypertension, Mild LVH (1mm), SVT, Gerd, prediabetes, Factor V Leiden. History of alcoholism, sober since 2013. PTSD, Depression. Meds=carvedilol, amlodipine, benadryl, ranitidine, pantoprazole, valerian, lorazepam approx 1-2 times per week, vitamin D3, fish oil, vitamin B12.