What history is characteristic of anti-MuSK-positive 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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Anti-MuSK-positive MG has several clinical characterisitics that differ from more common anti-ACh-R-positive myasthenia gravis. It occurs predominately in women with onset typically occurring in the fourth decade of life. In the United States, it is preponderant in African-American women. Patients with anti-MuSK antibodies have severe faciopharyngeal weakness with complaints of difficulty speaking and swallowing. They may have facial and tongue muscle atrophy and may mimic ALS. [31] Some patients have early respiratory muscle and neck weakness and present with dyspnea and neck pain. Most MuSK-positive MG patients have little or minimal associated ocular symptoms. [30]  Myasthenic crisis is also more common.

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