I think the decision to take or be prescribed prednisone depends on a lot of factors. I know that for me, my neuro. is only currently prescribing Mestinon and plasma exchanges as well as IViG. She hasn't attempted to prescribed prednisone for me. May be because my symptoms are mainly bulbar (weak face, slurred/nasal speech (with no ocular symptoms, oddly)). Also, mine is pretty severe (I have a thymoma, so that might be why, not sure though). I read a lot of things that indicated that prednisone can temporarilly make the symptoms worse, so she might be worried that I'll stop breathing or something. My immune system is also a bit on the weaker side when it comes to the things it's supposed to be destroying! All in all, I'm pretty relieved at the moment that I'm not taking it. My dad has been taking it for dermatomyositis for 12-years. He has osteoporosis and a number of other problems due to the pred.. On the other hand, pros and cons must always be weighed. Taking prednizone might be really helpful for a short time and might keep the symptoms at bay for a long time.

If your symptoms are limited to your eyes (ptosis/double vision), I've read that it's common for only mestinon to be prescribed.

All in all, I think docs. try to avoid prescribing it if they can get away with that (i.e. the patient will do okay without it). I've had arthritis for quite a few years as well. It's not severe, but it can be pretty painful. My rheumy has never suggested taking prednisone for it, even though it's autoimmune.

P.S. Sorry for the long post! lol