neck muscle problem
 

my neuro says that it nothing to do with mg and hence I asked my family doctor to refer me to a spinal specialist as recent x rays at A&E showed spurs etc in the neck area.
I already have spinal stenosis at L4 and L5.
Do you have the neck muscle problem?
Does your neuro believe yours is mg and muscular?
I have recently discovered a tool to help me not with the neck problem but the effect it has on other muscles when the neck muscles are not working.
I use a massage vibrator which can identify the muscles in spasm or where the muscles fibres are twisted.
It does this by bouncing badly on these muscles and when the muscle has been straightened out it vibrates smoothly.
Using a variety of tools you can cover every muscle ,joint and trapped nerve in your body including your head,face,neck,shoulders,elbowss,wrists,hands(yes hands)chest,body,legsand feet.

Scale 1gm pres =10mg mestinon just for talk sake
 

therefore in any 24 hrs 60mg pres. =600mg mestinon.
my neuro has currently set my mestinon at 90mg 4 times per day =360mg
total 960mg mestinon every 24hrs.
this 90 was feedback from me no testing at a time I had neck problems.
he wanted to use 60mgs pred =600mg mestinon plus 3 *60 every 24hrs coming out of hospital.
total 600 pres plus 180 mestinon=780mg
my strength in all areas bar my neck is fully there at 60mg pres or equiv 600mg mestinon.
If the object is to control mg at lowest level of drugs then I am still on overdosw at 600mg or 60mg of pres per day.
if the object is to load up to kill off the mg i wish the nuro would tell me.
since I believe I am in overdose I have reduced the pred to 50mg pred and will hold it there until i can contact neuro.
my neck problem he says is not neuro .hence the referral to spinal for pssible cervical neck check.
no use using mestinon to cure it if it not mg.
I hope this explains my reasoning maurice.

Patrick, my neck muscle weakness is definitively MG related as it is part of a general muscle weakness and also as it fluctuates during the day depending on my Mestinon intake.
If your neck weakness is permanent and if your other muscles are more or less OK, I would also agree that your problem is probably more spinal than MG.
One last thing about Mestinon, if I needed 360 mg per day, I would obtain better results by taking 60 mg every 3 hours, or even even 2.5 hrs for the first half of the day and every 3.5 hours for the other half.
But I have generalized MG...
I hope you'll find proper answers for your case.
Maurice.
PS: I never heard before that rule of thumb you mentioned, 1 mg Pred=10 mg of Mestinon...