Diagnosing MG

[Mermie]

I recently had an MRI because I developed double vision overnight last fall. They found a small pituitary adenoma, graves disease in my eyes (I had been treated thirty years ago with radio active iodine for graves in my thryroid -then developed a tumour, subsequent removel of most of the thyroid - the pituitary tumour two years ago, paralysis of vocal cord and right arytenoid, lazer reconstructive surgery last year) and white patch disease in my brain with demylienation. I recently saw an opthalmologist after searching for NINE months for one who is familiar with Graves in the eyes and he confirmed the diagnosis, and said I need eye alignment surgery but that he suspects something else is going on according to his examination and my MRI. I also ahve difficulty breathing if I exert at all but I put it down to my throat surgery. Weakness on right side, and a permanent lid lag and extreme lid lag with eyes following a light or pencil, according to the specialist. He wants me to be checked out for MG or MS. Which way should I go first? I am getting confused because I have been bounced around from doctor to doctor and I don't know which way to go. Thank you for your time and consideration,
Mermie
New Brunswick, Canada

[CCF-Neuro-M.D.-CS]

The typical patient with myasthenia gravis (MG) has intermittent symptoms which fluctuate from day to day. The deficits in MG are exacerbated or uncovered with activity which results in the muscle developing weakness. From what you described it sounds more like a fixed problem. Also, you have white spots and demyelination on a MRI. Therefore, it would be reasonable to exclude MS first and then consider other diagnoses. You should be able to see a neurologist for this problem. Good luck.