Sorry to hear about your diplopia - I have it too and it's awful . couple of tricks that have worked for me and might help if you wear glasses: go to your eye doctor and get Frenel Prisms for your glasses (they stick on and can help - though it's tough if your diplopia changes frequently). When the prisms aren't working I take strip of a post-it note and cover the center of one lens in my glasses - works perfectly though I look ridiculous. Diplopia is tough to "cure" with meds but it's possible. I've tried mestolin, prednisone and Imuran, but no luck so far.
As for diagnostic tools - there are several. Ice test will not work for diplopia. Single fiber test is a good indicator. blood tests are often false negative. MG without Ptosis is common. That's what I have. It's an ever evolving disease so don't be surprised if you have some symptoms one day and different ones the next.

Thank you!

So now I know that MG can happen without ptosis and diplopia won't improve with ice pack.

I read your first post and got to know more details. But without any affirmative tests / medicines not improving the situation, how did the Neurologist confirm MG. I'm in exactly the same situation.

Sorry your having a tough time but all my test were negative also. All of the blood work and emg were negative. My neuro started me on mestinon and I had little improvements now I am on mestinon and prednisone and a huge improvement began after 5 weeks of treatment. Also I changed neurologists 4 times until one wanted to treat me for mg. I had one who said that it was all in my head and another one who told me to live with it no treatment. Keep your head up and follow your own condition. hope this helps a little

My neuro had suggested me mestinon. Started with 30mg thrice a day and then increased to 60mg thrice a day. But there was no change in double vision. I had it only for 2 weeks. Doctor did icepack test after this and measured my diplopia and found no improvement. Then he said, I'm not having MG as the icepack test failed.

Do you currently have double vision?

Did you stop taking the Mestinon after taking it for 2 weeks because there was no improvement with the double vision?

Hi and welcome to the group. Sorry to hear you are having these problems.

I didn't get much help with the double vision with mestinon only, it took a few months of prednisone to get that under control. If I took 90mg of mestinon in a single dose, I did notice the double vision was better (mine was one image above the other) -- the two images got closer together, but not quite line up.

The double vision and jaw getting tired do seem like MG symptoms. The single fiber emg test is probably the one that is used most for difficult diagnoses.
Good Luck Russ

Yes, i have double vision even now. I stopped taking mestinon. Neuro said it's not MG as the icepack didn't improve double vision. But from what i read everywhere, icepack will improve only ptosis and not diplopia. Now I'm not sure, what to do next.

Re: Mestinon. In my own case. I took Mestinon for 30 days (Three 60mg pills each day. One pill every 8 hours. Never missed a dosage. Took it at 4:00am 12:00 noon and 8:00 pm. The first dose was exactly 8:00 pm on February 10, 2017. Took this amt. until March 13th, 2017 The double vision did not go away.

I called my Neurologist and complained that I had no improvement what so ever in the double vision. He wrote a new prescription and told me to start taking 2 pills ever 8 hour.

My calendar that I keep shows that on Monday March 13, 2017 I started taking 2 pills. That's 120 mg, three times each day for a total of 360 mg daily. On the 7th day of taking this amt, I woke up one morning and the double vision was gone.

As I type this, on April 7, 2017 my double vision is still gone and I am still taking the same 360 mg each day of Mestinon. My neurologist said that I would be taking Mestinon for the rest of my life.

Additional Info. I get tired during the day, rest a little and bounce back.
A Cat Scan of my chest was done on February 17, 2017. I wanted surgery to remove it but the results of the scan were that the Thymus was so small it is barely visible.

I can deal with this for the rest of my life if my condition stays the same ... but if my condition gets worse, if things change, then I will deal with the other drugs.

Right now ... my Neurologist says Mestinon is the thing for me to use.