Are normal nerve conduction tests co... - Myasthenia Gravis...

Myasthenia Gravis Association

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Are normal nerve conduction tests conclusive

Tinker5 profile image
6 Replies

Hello everyone I have been told over the years that there was a good possibility of me having myasthenia due to ptosis of my eyelid, exotropia, exophoria, double vision and debilitating head drop syndrome and some other things as well.

but my neurologist is telling me that the nerve conduction studies I have done including EMG were all normal. Are they a definitive answer?

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Tinker5 profile image
Tinker5
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TSH110 profile image
TSH110

Not sure. Did they find any antibodies? I had some signs in the nerve test but not enough to be diagnosed. I only had ptosis which has resolved on NDT so I suspect my symptoms were due to under medication of thyroid hormones, not MG. I had no antibodies but 30% with MG have none detected. It can go into remission as well.

tallyho profile image
tallyho

I have OMG I am negative for all tests but having tried mestinon tablets I had a positive response so since they worked and only do so for OMG I am still considered to have it.

TSH110 profile image
TSH110 in reply to tallyho

That’s most interesting. What are the symptoms of OMG? My eyes are really playing up of late.

tallyho profile image
tallyho in reply to TSH110

Ptosis and Diplopia mostly.

TSH110 profile image
TSH110 in reply to tallyho

I don’t have the ptosis now. I did wonder if mine is TED. I thought I had it when I first got diagnosed with atropic autoimmune thyroiditis which is more like graves initially but it burns out to hypothyroidism with occasional overactive bouts until the final dump of the thyroid’s thyroxine- it was not very nice! I didn’t get treated until after the last phase and I was very ill indeed. I was never diagnosed with TED but I had double vision, bright light was hellish and I saw terrible star bursts around all lights. The ptosis started up after being treated with Levothyroxine. I just wanted a Botox injection to get the eyelid back up again cos I read it was the treatment for it. It was never once mentioned. to me as a way to improve it. The nerve test reminded me of Frankenstein with those involuntary twitchings - it was very weird I had a huge black eye afterwards too. Now my eyes are puffy and swollen the corneas swell up I am plagued by blepharitis and Dermodex mites. They look crazy and staring which is a bit worrying. I think there must be an underlying reason for all these problems but no one at the opticians is interested in finding out what could be the root cause. I read you can develop TED years after even if there’s no functioning thyroid gland (mine shrivelled to a tiny crisp and the endocrinologist said it was highly unlikely to have any function whatsoever) because it’s related to the thyroid stimulating antibodies which can still attack the eyes.

My eyesight is ok with correction so that’s a relief.

I don’t think I can have MG.

DunwichWilbur profile image
DunwichWilbur

Obviously I'm late to the party. I'd been putting up with proximal leg weakness for 2+3 years, much worse in the hot weather, so much I stopped gardening in the summer and let most things die, and also late afternoon fatigue such that that by 3pm I couldn't get out of a chair/off my sitting stool without pushing off with my arms, and by quitting time @6pm I was angry, but not concerned. One summer, I thought about getting blood tests for MG at an Urgent Care - my mother has Ocular MG- but didn't. One evening as I was leaving work, I noticed 2 identical cars approaching me from the left, that merged in the center, and I knew how to deal with it, but I couldn't ignore it. The next day I saw my ophthalmologist, who impressed me with her exam, and said "This must be MG!" She Set me up for blood work and brain and upper spine MRIs and I saw my wife's neurologist shortly. During the exam, we re- produced my double vision, but I was shocked when he easily pushed down both of my legs flexed at the hips with just one finger! Damn, I thought. He reviewed the ophthalmologist's labwork and MRI and supplemented the labwork and ordered the EMG. ALL ANTIBODIES were NEGATIVE, MRIs and other labwork unremarkable and I had a NORMAL EMG. He ordered a Single Fiber EMG test which was specific/? sensitive for MG and it was (+). His partner was trained to perform the test which otherwise might not've been available. I'd had the disease for years but had only 1 positive test. (My mom was Ab(+) on first test after just weeks of double vision.) Now I have a positive Ach receptor Ab test, so I can get Vyvgart infusions to treat it, since I'm getting significantly worse this summer despite Cellcept and prednisone.

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