A patient complains of a long history of generalized muscle weakness. On examination, his facial muscles show marked atrophy as shown and when you ask him to shake your hand , he is unable to relax the grip for quite some time. Ophthalmological examination reveals the following finding: ECG showed the following finding: Which of the following given condition is not seen to be associated in above clinical scenario?
Congestive hea failure Malignancy Intellectual impairment Insulin resistance