Questions posted in the
Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.
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Subject: Confused and Concerned I was recently diagnosed with MG by two neurologists (opinions 1 and 3). My symptoms are minimal and clinically difficult to see, this according to both Drs who made the diagnosis. CT scan of chest and blood immuno test negative; the diagnosis was made on the strength of repetitive nerve stim test. Results were in the 15-22% decrement range after 3 and 5 minute intervals on shoulder, not much more than 7-8% on hand at any strength or interval. Both agreed that Tensilon (sp?) test not necessary. Am now on 30 mg mestinon x3, with no other treatment. I feel great! They recommending thymectomy ASAP for full possible benefits. I saw another neuro (second opinion) who said clinically he sees no way re MG (I'd be the rarest case he's seen in 40+ years) and is unimpressed with the Harvey-Maslin (sp?) test results. Is inclined to believe it's stress related. (Other Drs diplomatically suggested that he may not be familiar with what to look for in the way of results...) Questions: Should I have another neuro clinic do the rep nerve stim test over again to be certain, or does your experience show that once is enough (While I don't look forward to that test, it is much less critical than a thymectomy!) If not, or if the 2nd test points clearly to MG, given my age (42) and very good health at this point, are there studies available that may give me some idea of how much this disease might progress and in what time frame? Or am I going to be told by most if not all reputable, MG experienced neuros that the thymectomy is the way to go? Last, even with a thymectomy there's a good possibility that the symptoms could recur and even worsen, correct? As you may be able to tell I'm not keen on major thoracic surgery... | |
