Okay, good. I would suggest that you get a referral to Mayo Clinic in AZ. Why? It is possible she has a CMS. Yeah, it could be MG but without a positive antibody test, you need to make sure. You don't want to even consider the immunosuppressant path until you know whether this is a genetic issue or an autoimmune one. Not that they would do immunos for a child! But if she gets worse, they may have to try something. Mayo would probably redo the antibody tests, including MuSK, and they can do the genetic CMS blood tests.

What ancestry are you? There are certain genetic populations - like Northern Europeans - that get CMS more often.

Annie