Table of ContentsView AllTable of ContentsFrequent SymptomsRare SymptomsComplicationsWhen To See a DoctorNext in Myasthenia Gravis GuideCauses and Risk Factors of Myasthenia Gravis
Table of ContentsView All
View All
Table of Contents
Frequent Symptoms
Rare Symptoms
Complications
When To See a Doctor
Next in Myasthenia Gravis Guide
The most common symptom ofmyasthenia gravis(MG) is progressive weakness of the skeletal muscles—the muscles that allow the body to move. “Myasthenia gravis” literally means “grave muscle weakness.”
This condition typically affects facial muscles, especially in the eyes, but can also affect muscles in other body parts. In addition to muscle weakness, MG causes severe fatigue and, in rare cases, can lead to respiratory failure.
There is no cure for MG, but treatment can help manage symptoms, including muscle weakness of the limbs and eyes, problems with speaking, chewing, swallowing, breathing problems, and debilitating fatigue.
This article discusses the common and less common symptoms associated with myasthenia gravis
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MG is an autoimmune disease where abnormal immune system responses cause autoantibodies to block or destroy certain muscle and nerve receptors. The result is interrupted communication at the neuromuscular junction—the area where nerve nerves connect to muscles they would control. When this happens, nerve impulses are prevented from triggering muscle contractions.
For most people, the onset of MG is gradual and often, signs and symptoms are not immediately noticed. The severity of symptoms will vary from person to person.
MG can affect any of the voluntary muscles, but it tends to affect specific muscle groups. The muscle groups most frequently affected are the eye muscles, the face and throat muscles, and the arm and leg muscles.
Muscle Weakness
Weakness associated with MG will get worse with activity and improve with rest. The degree of muscle weakness will vary for each individual affected. It can range from a mild form where only a few muscles are affected to a severe form that affects many muscles.
MG may cause the skeletal muscles to get weaker with time, especially if the condition is not treated or undertreated.
Eye Muscle Problems
Eye symptoms of MG include:
For many people with MG, eye problems are usually the first symptoms experienced with MG.
Face and Throat Muscle Weakness
Myasthenia gravis can cause symptoms in the face and throat muscles.
Symptoms related to the face and throat muscles involve:
Weakness of Other Body Parts
Muscle weakness in MG can eventually spread to the neck, arms, hands, legs, and feet. Once this happens, a person with the condition may not be able to lift their arms over their head. They are not able to perform physical tasks, including walking long distances, climbing steps, getting up from a sitting position, and gripping heavy objects.
Constant tiredness and aching muscles after physical activity are also common with MG. Achiness and tiredness are usually worse in the upper part of the body than in the legs and feet.
Debilitating Fatigue
Together with muscle weakness, fatigue can severely affect your life enjoyment. It can make you too tired to participate in your favorite activities, to spend time with loved ones, and to be productive at home and on the job. It will cause you to feel sleepy even after sleeping a full night’s sleep.
Treatments for MG can be helpful in improving fatigue levels for some people. But for others, life with MG fatigue can be challenging and negatively affect quality of life.
MG can involve the diaphragm and the chest muscles that help with breathing.A myasthenic crisis can cause breathing to be fast and shallow or ineffective. The airway can also become blocked from secretion buildup and weakness of throat muscles.
Myasthenic crisis affects up to 20% of people with newly diagnosed MG.It is also common in people who are untreated, who are slow to respond to treatment, and who have rapid disease progression.
Certain triggers can make MG symptoms worse and may lead to a myasthenic crisis.Such triggers include stress, lack of sleep, sickness, overexertion, pain, extreme weather temperatures (hot or cold), hot showers or baths, some foods and beverages, and chemical exposure, such as with lawn treatments or insecticides.
Some commonly used medications likecalcium channel blockers,lithium, verapamil, and some antibiotics have been known for making MG symptoms worse.
A myasthenic crisis is treated with mechanical ventilation and intubation. Mechanical ventilation uses a breathing machine called a ventilator to move air in and out of the lungs.To connect the lungs to a ventilator, a healthcare provider inserts a narrow tube into the mouth to the windpipe in a process called intubation.
In a severe myasthenic crisis, a person will be on a ventilator until their muscle strength returns.
What Is Myasthenia Gravis?
Complications/Sub-Group Indications
As with other autoimmune disorders, people will MG will go on to develop additional conditions. Further, MG seems to affect females much more severely than males.
Comorbidities
The term “comorbidity” is used when referring to the presence of more than one medical condition affecting the same person.Females with early onset of the disease have the highest incidence of comorbidities, including other autoimmune diseases.
Comorbid conditions associated with MG includedyslipidemia(abnormal amount of lipids in the blood),thyroid disease, diabetes, hypertension, andautoimmune diseases, likerheumatoid arthritisandautoimmune thyroid disorder. Comorbid conditions can contribute to poor treatment response and decreased quality of life.
Disease Severity
In an observational, cross-sectional population study reported in 2016 in the journalPLoS One, researchers aimed to quantify muscle weakness in MG.They wanted to determine if gender, treatment intensity, and disease duration affected muscle strength and disease progression. Researchers determined muscle weakness was more evident in the female study participants.
In addition to affecting females at earlier ages, early onset MG has been associated with higher rates for hyperplasia (enlargement of thethymus gland) and higher levels of acetylcholine receptor (anti-AChR) autoantibodies, which means more severe disease symptoms.
Anti-AChRs proteins are located in skeletal muscle fibers. In MG, they are the target of auto-antibodies responsible for causing the disease and keeping it active.
When To See a Healthcare Provider/Go To the Hospital
You should see a practitioner if you experience sudden-onset weakness, fatigue, or pain and don’t know the cause of these symptoms. You should contact your healthcare provider if you find you are feeling well one minute, and then suddenly you feel severe exhaustion, pain, and/or other severe symptoms you have never before experienced.
You should see your healthcare provider if you experience any of the eye symptoms associated with MG, including blurry or double vision, droopy eyelids, or tired eyes. Mouth or jaw weakness affecting chewing, swallowing, or facial expressions, or causing slurred speech should also be checked out.
When To Go To the Hospital
Sudden weakness in certain parts of the body might indicate a more serious problem. For example, if you are experiencing severe muscle weakness or numbness on one side of the body or in the face, you should go to the emergency room.
While some of these symptoms are seen in MG, if these are new symptoms or are severe, they may indicate astroke. Other stroke symptoms include confusion, slurred speech, face drooping, and weakness in the legs.
A myasthenic crisis may require you to go to the hospital. If symptoms do not appear life-threatening, reach out to your healthcare provider for advice. However, if you cannot get hold of your practitioner, if you find you are having severe breathing and swallowing difficulties, or your weakness worsens quickly, get to an emergency room right away or call 911.
A Word From Verywell
Most people with MG live a life with few flare-ups provided they stick with theirtreatment plans. The condition can spread across the body and some people experience significant symptoms and severe disease activity. While death from complications of MG is possible, most people with the condition will not see a change in life expectancy.
Symptoms of myasthenia gravis can improve with treatment. The goal of treatment is to improve muscle function and prevent any swallowing or breathing problems. With effective treatment, most people will experience muscle strength improvement and will lead normal lives.
Of course, not everyone with MG will respond well to treatment or see immediate symptom improvement. Some may need therapy for swallowing and breathing. You should work with your healthcare provider to come up with an appropriate and successful treatment plan to improve disease symptoms and quality of life.
13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Institute of Neurological Disorders and Stroke.Myasthenia gravis fact sheet.
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Nair AG, Patil-Chhablani P, Venkatramani DV et al.Ocular myasthenia gravis: a review.Indian J Ophthalmol. 62(10):985-991. doi:10.4103/0301-4738.145987
Wang S, Breskovska I, Gandhy S, et al.Advances in autoimmune myasthenia gravis management.Expert Rev Neurother. 2018;18(7):573-588. doi:10.1080/14737175.2018.1491310
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Patel BK.Overview of mechanical ventilation. Merck Manual.
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Meghani SH, Buck HG, Dickson VV, et al.The conceptualization and measurement of comorbidity: a review of the interprofessional discourse.Nurs Res Pract. 2013:192782. doi:10.1155/2013/192782
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