Ganglionic ACHR is different than Muscle ACHR. Positive muscle ACHR antibody causes MG. Positive ganglionic ACHR antibody causes AAG - autoimmune autonomic ganglionopathy. I found an article that MG patient after 3-5 years show cross-reactivity with Ganglion ACHR as described in #2 above. I think that what gives me some of my non-typical MG symptoms that coincide with my MG course like severe tinnitis, acid reflux, diarrhea and profuse sweating. All this is controlled by the autonomic nervous system. These other symptoms are worse when the MG is worse or when the mestinon is wearing off and subside when the MG subsides or with a dose of mestinon.

thanks
kathie

That is a good point! I´ve heard members here say that MG can affect more than just the standard voluntary muscles in the body. After years of working with over the limit decibel exposure I put the hyperacusis (severe) and tinnitus (mild) all down to hearing damage over time. It was so bad I was wearing musician´s earplugs with special filters to protect those tiny delicate little muscles and be able to go about my normal day.

Much to my amazement after this many years of having it, the hyperacusis and tinnitus have gradually disappeared in tandem with the other myasthenic weakness for eg, eyes, breathing, swallowing, deltoids, trunk etc etc over the space of a two year period.

It is very odd to have all the myasthenic layers peeled off and be left sitting there with the slight noise damage in my left ear that I had all those years ago before I started suffering from myasthenic muscle weakness.