Jenny,

We have some really knowledgeable people here, and I hope they will respond with some suggestions. Meanwhile, I have a piece of general advice, which you may already be doing: keep a journal! Write down what you ate and when, what activities you have been doing, how much sleep you got, what the temperature and weather is, whether anything emotional is going on, where you are in your cycle (if you have one), and everything else you can think of. I thought I had a good handle on my triggers until I tried journaling just for a couple of weeks, and I was amazed at the connections I'd missed.

Has anyone ever mentioned hyperkalemic or hypokalemic periodic paralysis to you? If not, it may be worth typing into google.

One thing I've noticed: when you read about MG, you don't really read about it coming in "episodes" like you describe, but I think for many of us it does. I have normal MG symptoms that gradually worsen as I get tired. But I also have short-lived (lasting less than an hour) episodes where I suddenly get very weak. I sometimes end up on the floor because my legs are simply too weak to hold me up. I don't crash down--it's more of a slow collapse. I don't black out, and my "episodes" aren't nearly as severe as the ones you describe. But I think of my MG as causing two problems: the general weakness, and these "spells." It's not that they're unrelated--the spells tend to happen when I'm especially weak--it's just that they are two separate things to deal with.

I hope you get some answers soon.

Abby