Hi, dasw. Would you mind saying what tests she has had? There are three antibody tests: AChR (acetylcholine receptor), MuSK, and LRP4. Has she seen a neuro-ophthalmologist? They can do specific tests to determine if she has fatigable muscles in the eye area. And they can clearly show if she has double vision, which is from eye muscles not focusing the eyes the same way.

There are areas in Pennsylvania that have MG experts. There are many MDA clinics across the country that have "free" visit days. This might take some calling around, but will be well worth it.

http://www.myasthenia.org/LinkClick....4%3d&tabid=306

Muscular Dystrophy Association

Hospital of the University of Pennsylvania | Muscular Dystrophy Association

Please have her get copies of all her tests. Sometimes doctors do not consider a low abnormal test to be abnormal! Seriously.

The important thing is to have a diagnosis, whatever is going on.

Has she taken photos of her eyes, such as first thing in the morning and then later in the day? Does she have double vision? Does that go away when she closes one eye (which is typical of MG double vision)?

MG rarely stays ocular. If she starts to have any other symptoms, such as head or neck weakness, swallowing issues, etc., she needs to see a neurologist (expert or not) right away.

Sometimes we have to see more than one neurologist or different specialist (i.e., neuro-ophthalmologist) to be diagnosed. Please call around to find someone in the area she can see. Calling the insurance company might help as well. If there is no one in New Jersey who can do a SFEMG to diagnose her, she has the right to go elsewhere. They might have a recommendation or be able to say which out-of-state provider would be covered.

I hope she can find someone to help her. If there's more she needs to know, please let her know that she is welcome here! Thank you for helping her!

Annie