Question: Dr. XXXXXXX

I have messaged with you a couple of times over the past weeks. I have had my follow up neurology appointment. My exam was once again normal with brisk reflexes in the knee as the only abnormality. I showed him video of my calf fasciculations and cramping in my hand. He decided it is time for an EMG which I had a clean EMG after the initial onset of fasciculation. I still have no clinical weakness or loss of sensation. Is it possible to have a neuropathy either sensory or motor with a normal neurologic examination. I also mentioned to him my fear of paraneoplastic disease which he mostly dismissed and said the only possibility worth mentioning with my symptoms would be stiff many syndrome which generally is not paraneoplastic. He was not willing to do any antibody testing until my EMG results come back and have major abnormalities. He placed me on gabapentin. I have now had neurologic symptoms for 11 months. If this was something terrible motor neuron disease/ paraneoplastic syndrome would I be severly disabled by now. I still am abe to attend work.
My concerns are that the headaches that I am having don't feel like any normal headache, they feel as though my brain is being attacked. My chest has continued pain in the sternum with a cough very rarely(1-2 times per day) going on 3 months, and I feel dizzy disoriented and very much anxious about these constant symptoms.

With additional neurologic exam I am interested to see what you think.

Thanks in advance.