I've been having bad cramps on and off, mainly in calves and bridges of feet, since I was about 14....It would just be a momentary thing, so I have never really addressed it with my doc.. When my MG symptoms started to get really had, though, (Slurred/nasal speech, shortness of breath), I started getting really bad twitching in my fingers, mainly on my left hand...My middle, ring and index fingers twitch uncontrollably if I extend them. I also have hand weakness...This is all before mestinon, mind you....So it's definately NOT from that....I also have a lot of swelling in my hands too (not sure if related)...Anyway, I brought it up to my thoracic surgeon...He mentioned that having thymic abnormalities (thymoma/hyperplasia) can sometimes cause symptoms like these...When I did a bit of research on it, I came up with some 'overlap' syndromes that can occur with MG and especially MG with thymoma. The main ones I came across were neuromyotonia, cramp-fasciculation and Morvan's syndrome (which might be the same as cramp-fasciculation)...

One thing that I find helps, and I'm not sure if this might apply to any of you guys, is I smoke (which is really really bad, I know :S *embarassed*) and drink a lot of caffeinated drinks. If I don't smoke and don't have these beverages for a couple of weeks, the cramps/fascits aren't as bad and almost disappear...I also drink a lot of milk and water which seems to help...I think it might have to do with stimulants for me and inbalance of electrolytes...and oh yeah, a crazy immune system! lol