I have not heard back from the neuro office yet. But the symptoms have gone away and they did not repeat with her 3rd dose but we spaced that one a little farther out. I am going to space the doses today out to 5 hours instead of 4 and see if it helps. After this mornings dose one eye that had mild ptosis is better the other that more ptosis is better but only marginally.

She has had a few symptoms of generalized over the past few months so I am also having her pay attention to those - although they are mild and hard to tell. She has had a few times after activity were she has difficulty holding onto things with her fingers - only lasts a few minutes if she rests. She has also had a couple times were she has felt she could not lift a child she babysits and also had to sit down because her legs felt week. Last weekend we went camping and by the end of the day the entire right side of her face was drooping some. The ptosis has never progressed passed half closed in her right eye yet. She has had very limited boughts of double vision - more like a shadow behind the object. This all has came on fairly quickly. pics form Nov-Jan show no signs. Mild signs began to show up in photos in Feb and by March I noticed it visually. I can not pinpoint an illness or event that may have contributed to it starting.

She has not been tested for MuSK yet but that is one they will be doing next. The neuro specialist who did the emg and started the medicine is not our first contact neuro so we are waiting for them to confer and for the results of the week of medicine to decide on a future course.

Oh my that got long I am sorry. I am so glad to have found a site with so many who have experience with MG. It is quite a confusing disorder. Thank you all for your replies.