Although I had some word finding difficulties, I remember a long stretch of progressive myasthenic weakness in a classical pattern over a two year perod. Like some of you, by 4.30 p.m. I may have been falling into my dinner plate with weakened trunk muscles, could not chew my food or keep my voice in from becoming dysarthic. Yet nevertheless, I could, at the exact same time, speed read my neurobiology books equally well - no matter what time of day it was and regardless of the diurnal fluctuations the other muscles were having. That discrepancy was always there. Like any myasthenic, when you are constantly negotiating fluctuations in muscle strength and using strategizing techniques on a daily basis to impact task function - it might end up working both ways. But for me at that particular time, the effects were positive. So whilst other muscles may not be listening, your brain might just be getting the work out of a lifetime you otherwise never would have had.

Anacrusis