What are oropharyngeal symptoms 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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Up to 20% of patients with MG may have prominent oropharyngeal symptoms early in the disease course, including dysarthria, dysphagia, and difficulty chewing. [33] Weakness of palatal muscles may confer a nasal quality to the voice. Speech may become slurred (from weakness of the tongue, lips, and face), which may worsen with prolonged talking (e.g., talking on the telephone or giving a speech or presentation). Although the speech assumes a nasal intonation (from weakness of the soft palate), there is no impairment in fluency in speech.

Chewing may become difficult and often patients may actively open and close their jaw with their hands. Severe jaw weakness may cause the jaw to hang open (the patient may sit with a hand on the chin for support). Swallowing may become difficult, and aspiration may occur with fluids, giving rise to coughing or choking while drinking. Liquids are more difficult to swallow than solid food. Often, patients will complain of nasal regurgitation of liquids. Coughing, nose-blowing, or throat-clearing may be noted.

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