My first symptom was just a droopy eyelid. It was almost completely closed. It came on suddenly on a long trip. Concerned about a stroke, I went to the ER. Our hospital just started an urgent care facility that I thought was competing with the commercial urgent care facilities, sort of a pre ER, but the prices they charged Medicare on my behalf were ER prices. They said that because the rest of the face was not involved it was not a stroke and referred me to an ophthalmologist. The first diagnosis was Ptosis, but a need for cataract surgery was also diagnosed .It was not until after double vision, tunnel vision, getting very tired but recovering quickly etc occurred that MG was suspected and then confirmed with the blood test. I was then referred to a Neurologist. Now, 10 weeks and 11 doctor visits later I am now in treatment with a CT scan of the chest, muscle fiber test, and for some reason a sleep APNEA test in the process of being scheduled. All of us with MG seem to be different, and MG is a very serious disease, but if your whole face droops before the other eye symptoms start, are you sure you don't have something even more serious?
A negative ACHR does not mean you don't have MG but a positive one is a very strong indication that you do.