Lizzie,

I think that you missunderstood me.

so let me clarify what I was trying to say. there are many reasons as to why it is sometimes very hard to diagnose MG, or even know when there is a flare up, that requires change of treatment or just the usual "ups and downs" of this illness. many MG symptoms may be easily mistaken for "something else", usually in the field of psychiatry, even in "classical", seropositive patients.

this has nothing to do with the doctor being "good" or "bad" or with the patient being "good" or "bad". it has to do with the way this illness is.
and the very variable presentations.

the fact that a neuorogist tried to explain those difficulties during a conference is very good evidence for that. as it goes without saying that you would not treat a patient without being sure of the diagnosis. so why even mention it?

do you think that an oncologist during a conference for patients with cancer would say- we are reluctant to give chemo. to a patient without being sure that they actually have cancer? I truly doubt that.

the problem is that many times, this situation is very frustrating for both the physician and the patient. most neurologists do not feel comfortable saying to their patient- look, what you are describing is very typical of MG, your neurological examination may be normal, because we don't really have the tools to asses MG weakness very well, you don't have antibodies, because about 20% of the patients don't have them, your EMG may be normal, because this test is not as accurate as we would like to think, and probably even less useful in seronegative patients like you.