Thanks for the reply, Annie.

I saw a very senior clinical neurologist who specializes in neuromuscular problems. He did quite a few blood tests including MuSK, although I did not see the LRP4 test (I thought that was just experimental?). I live in the UK.

He referred me to the emg specialist (electrophysiologist?) for the single fiber EMG. He tested all over the body to the best of my knowledge including my legs, but he said it was only abnormal in my ocular muscles. Both left and right sides. He repeated the test twice in two different clinics to make sure as he could not believe I did not have ocular symptoms. He said only MG fits my symptoms (generalized fatigue after exercise / infection) and not any others that would produce a positive EMG. What the tests for LEMS be?

I bought Galantamine myself as I read it was a natural substance that achieved the same end point as Mestinon (more acetycholine). Have you tried Huperzine A? Have you considered stem cell treatment?

I will try to get a referral to a neuro-ophthalmologist. I am short sighted, but I do not think that is related. I have noticed I have to provide effort to focus at close range sometimes, so perhaps that is related.