Mangi, Your comment of "Extreme tightness in chest" explains your question to Annie59 very succinctly. MG is all about fatigable skeletal muscle weakness, that gets worse the more you do and better with rest. MG can affect any of the 640 skeletal muscles at any time. MG affects the chest wall muscles quite often, that's why seeing a pulmonologist will help to determine if your breathing is affected by whatever is going on. MIP (maximum inspiratory pressure) and MEP (maximum expiratory pressure) are specific to neuromuscular diseases and to see if that is the cause of any breathing issues. Make sense?

An overnight oximetery is often done with people who have MG, a test done by pulmonologists, because when muscles get weak, you can have trouble getting oxygen to your body. Muscles get even weaker when you sleep. MGers can have hypoxemia at night or sleep apnea. A full sleep study is often done but an overnight oximetery can show if you are getting enough oxygen while sleeping or not.

Have you seen a neuro-ophthalmologist? If not, they would be the ones to determine if the ptosis in your left eye is from MG or not.

The first tests often run on someone suspected of MG are the Acetylcholine Binding and Modulating antibody tests plus the MuSK antibody test.

A Single Fiber EMG is more sensitive for diagnosing MG than a regular EMG. There are not many doctors who perform it and do it well.

Your symptoms could be from a fish toxin but it's hard to tell unless the doctors do more specific testing!

The fact that you have weakness that gets better after you rest makes it sound like MG. MG is unique in that sense. There aren't many other disease that cause fatigable muscle weakness. LEMS (Lambert-Eaton Myasthenic Syndrome) and CMS (Congenital Myasthenic Syndromes) do too.

The old food and liquid going up the nose is common for those with MG. I can drink some Lacroix water and have it end up in my eyes. It's so much fun. If those "ENT" muscles don't work well, food and liquid won't go down into the stomach. Peristalsis, the way food gets moved through the GI tract, is also affected by acetylcholine and, therefore, MG.

In MG, antibodies attack the muscle receptors in the neuromuscular junction, damaging them and causing less "openings" for acetylcholine. The acetylcholine (ah-seat-ill-co-lean) which comes from the nerves and needs to go into the muscle receptors to make our muscles strong, now has fewer openings to get that to happen. Because not enough of it gets to the muscles, our muscles are weak to begin with and become even weaker when what little we get is used up.

Does that answer some of your questions? I hope you can find a neuromuscular expert who can help you. An MG expert would be best. Maybe contact your local MDA or look up the MDA offices or MDA Directors in your area: www.mdausa.org

You can get more info at www.myasthenia.org too.

I hope you can figure out what is going on. It's not fun to be undiagnosed.

Annie