all I can say, that it seems that like many things with this illness, this too is "backwards".

instead of a diagnostic test being one of the tools a physician has in order to figure out the puzzle and make the proper diagnosis. ( based on what the patient tells them, eg- the history, which in a fluctative illness like MG is probably the most important, the physical examination, and the ancillary tests).

it became somthing a patient has to prepare for, as if it was an exam. in the university, which you should pass in flying colors. (one pair of jitter is obviously not enough, so how many do you need and how do you "get" them?).

is it OK to say that this is ridiculous?

and I am not sure how exactly you can "prepare" for it.

it makes perfect sense to stop the mestinon, or anything else that you know affects your muscle strength, as obviously it could affect both the neurological examination and the EMG, but what else can you do?

I really don't think that you have any control over the results of you EMG, just like you can't control the results of any other test. and I think it is the neurologist's job, to make sure that it is done under the appropriate conditions and interpeted correctly, and put in the right contents, not yours.

a person can have myasthenia with a normal SFEMG.

and the diagnosis can not and should not be based on one single test.

just like a person can have a myocardial infarction with a normal EKG, and even leukemia with a normal blood count.

and they all should be properly diagnosed, even with those normal tests.

alice