What are the clinical characteristics of myasthenia gravis (MG)?

Updated: Aug 27, 2018
  • Author: Abbas A Jowkar, MBBS; Chief Editor: Nicholas Lorenzo, MD, CPE, MHCM, FAAPL  more...
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The presentation of MG has the following characteristics:

  • The clinical hallmark of MG is the presence of fluctuating fatigable muscle weakness that worsens with activity and improves on rest

  • 50% to 85% of patients with MG present with ocular symptoms with or without generalized weakness

  • 50% to 60% of patients with MG who initially present with isolated ocular involvement go on to develop generalized weakness, often within 3 years after onset of symptoms

  • The disease remains exclusively ocular in only 15% to 25% of patients throughout their course [1, 2]

  • Approximately 20% of patients with MG may present with prominent bulbar symptoms

  • Bulbar muscle weakness is also common, along with weakness of head extension and flexion

  • Limb weakness may be more severe proximally than distally

  • Isolated limb muscle weakness is the presenting symptom in about 5% of patients [3]

  • Weakness progresses from mild to more severe over weeks or months, with exacerbations and remissions

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