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Myasthenia Gravis

Response to Mestinon

02/22/2011

Question:

I`ve been been diagnosed with ocular MG based on ptosis and diplopia but am seronegative so I never anticipated generalized symptoms. I have noticed neck weakness and noted the ability to hold my head up from a supine position for about 40sec on first attempt, 20sec on the second and 10sec on third attempt (15 sec rest between). I tried mestinon (which has not helped the vision) to see if it would help the neck weakness and with 60mg nothing changed. Does this lack of change in muscle strength rule out generalized MG? Are antibody tests ever repeated? I`m 1 year from diagnosis. Thank you.

Answer:

The lack of a definite response to Mestinon does not exclude generalized MG.  Yes, we do repeat serological testing in some situations – this might be one.  Make sure that you are working with a doctor who is experienced in diagnosing and treating MG.  Many decisions must be customized to you, the patient.

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Response by:

John G Quinlan, MD John G Quinlan, MD
Professor of Neurology
College of Medicine
University of Cincinnati