Here is my experience. My local doctors in NJ were stumped, but sent me to a neuro-opthamologist for evaluation. I did't like this doctor and he acted like I was crazy until he found my eye muscles weren't working well on exam. Never the less he sent me for a Repeat CT scan of my brain and orbits ( previously done by my opthamologist) which was unchanged. I
I saw an ENT in NYC for another problem and he got me a quick appointment at a major teaching hospital with another neuro-opthamologist where I was given a preliminary dx of myasthenia on the first visit based on exam. Serum antibodies were drawn and proved to be negative. I was referred to a neurologist who did an inconclusive EMG on me. He stated that we could make another appointment for a single fiber EMG (as the test takes a long time) or he could do a Tensilon test right then in the office. I had the test, it was positive and had the diagnosis on that visit.
It should be noted that he sees myasthenics in the hospital where emergency procedures are in place should there be an emergency as Tensilon can sometimes slow your heart rate.
I have been on Mestinon and now Cellcept and am improved overall. the goal is to go into remission with and then without the Cellcept.
Hang in there, it is a journey