Hi, Paul. I'm so sorry for what you've been through.

Your neurologist should put you through some standard muscle tests, like pushing on his hand, walking on your toes, and holding your eyes up. I hope he will also do some standard blood tests to see if your muscles are releasing certain enzymes, that sort of thing.

If he thinks you might have MG, he will order a blood test to look for the antibodies. The most common antibodies are AChR antibodies. If this test comes back positive, it means you definitely have MG. If it comes back negative, you might still have MG (about 20% of people who have MG get a negative AChR test). He should then test your blood for other antibodies: MuSK and LEMS.

If all the antibody blood tests come back negative, there is one more test you can have that can diagnose you with MG, if you also have symptoms that fit. It's called a Single Fiber EMG (not a regular EMG). You will have thin needles inserted in your muscles, and the needles measure electrical signals in your muscles. Not every neurologist knows how to perform a SFEMG, so your doctor might send you to a neurologist who specializes in neuromuscular diseases.

What I've described is the typical route most doctors go in diagnosing MG. There are some other tests as well. Unfortunately, the whole process can take a long time. It can take several weeks for the antibody tests, and depending where you live, it can take a while to schedule a SFEMG.

Please feel free to ask questions here! The people here are just wonderful, and they know an awful lot. Many of us also know from personal experience what it's like to have an illness that's undiagnosed, or misdiagnosed, while it gets worse and worse. I hope you get answers very soon.

Abby