Hey, Nicky. I had to see my internist like about two weeks after being in the hospital for my crisis. I hold my mirror in my left hand to put makeup on. Well, my hand contorted and would not stop until I completely rested. It was scary to have happen for the first time. Since yesterday, for whatever reason, my right hand is really bad, even hurts. It's worse off of Mestinon and better on it and I have had increased neck/tongue/jaw weakness in the past two weeks. I doubt it's a coincidence.
I think it's odd how certain muscle groups flare at certain times. Like during my crisis when I could speak but couldn't move or breathe. Unlike you "bulbar" guys!
Anyway, that's my long answer to your short question. Have you been doing more with your hands/arms lately? I hope you feel better soon.
Annie