<s>[INST] what could be the diagnosis of progressive neuromuscular symptoms that start with double vision after then difficulty swallowing especially liquids unable to cough productively sleep apnea events muscle cramping ans spasms beginning with left leg toes curling under with big toe curled back to body the progress to both legs involved unable to stand and walk on feet with curled under toes. hiccups and muscle twitching at rest now on ventilator unable to wean off due to diaphragm weakness Unable to open mouth wide like locked in place [/INST] In my opinion you have Multiple sclerosis , i recommend you see neurologist if this roles out then you should check your liver function Good Luck </s>