Myasthenia Gravis Symptoms: Early Signs & Warning Signs

Myasthenia Gravis Symptoms That Should Not Be Ignored

The following are myasthenia gravis symptoms that should not be ignored and require a doctor's evaluation:

Symptom	What It May Indicate
Persistent eyelid drooping	Weakness of the muscles that lift the eyelids
Double vision	Weakness of the muscles that control eye movement
Difficulty chewing	Weakness of facial and jaw muscles
Slurred or weak speech	Weakness of the muscles involved in speaking
Difficulty swallowing	Weakness of swallowing muscles and increased risk of choking
Difficulty holding the head upright	Weakness of neck muscles
Difficulty climbing stairs or standing from a seated position	Weakness of arm and leg muscles
Increasing breathing difficulty	Weakness of the muscles involved in breathing

Having these symptoms does not automatically mean it is myasthenia gravis, since other conditions can cause similar issues. A healthcare professional can help figure out the true cause through a routine evaluation.

Why Do Myasthenia Gravis Symptoms Occur?

Myasthenia gravis symptoms occur when the immune system mistakenly attacks the communication point between nerves and muscles.

Normally, nerves release a chemical messenger called acetylcholine, which attaches to receptors on muscles and helps them contract. In myasthenia gravis, antibodies may affect acetylcholine receptors or other proteins involved in nerve-muscle communication. This prevents muscles from receiving normal signals, causing weakness that becomes more noticeable after repeated activity.

The thymus gland, part of the immune system located in the chest, is also associated with myasthenia gravis. Changes in the thymus gland may occur in some people with this condition. Symptoms may become worse with factors such as tiredness, stress, infections, heat, or certain medicines.

Myasthenia Gravis Symptoms That Require Immediate Medical Attention

Seek immediate medical attention if the following myasthenia gravis symptoms appear:

Severe or rapidly worsening difficulty breathing (myasthenic crisis)
Increasing difficulty swallowing food, liquids, or saliva
Frequent choking while eating or drinking
Sudden worsening of muscle weakness
Severe weakness during an infection

Symptoms of Myasthenia Gravis Based on Type

The table below explains the symptoms of myasthenia gravis based on the muscles affected:

Type	Symptoms
Ocular Myasthenia Gravis	Weakness limited to the eye muscles, causing drooping eyelids and double vision
Generalised Myasthenia Gravis	Weakness affecting eye muscles along with facial muscles, jaw, throat, neck, arms, or legs. Difficulty chewing, speaking, swallowing, walking, or breathing may occur

Symptoms of Myasthenia Gravis in Children

Myasthenia gravis symptoms can vary with age in children. In some children, early symptoms may affect the eyes, causing drooping eyelids or double vision.

Common symptoms of myasthenia gravis in children include:

Drooping eyelids
Double vision
Difficulty making facial expressions
Problems chewing or swallowing
Speech difficulties
Weakness in the arms, legs, or neck
Difficulty walking or climbing stairs

Can You Have Myasthenia Gravis Without Symptoms?

Myasthenia gravis usually causes noticeable symptoms, but in some people, they may be mild or limited to specific muscles. For example, ocular myasthenia gravis may mainly affect the eye muscles, causing symptoms such as occasional eyelid drooping or double vision.

Because symptoms can vary in severity, some people may not recognise the early signs immediately. A medical evaluation is important if symptoms persist, return frequently, or worsen with activity.

When Can Myasthenia Gravis Symptoms Become Life-Threatening?

Myasthenia gravis symptoms can become life-threatening when severe muscle weakness affects breathing or swallowing. The table below mentions the emergency conditions when the myasthenia gravis symptoms can be life-threatening:

Emergency Condition	Why Is It Serious
Myasthenic crisis	Severe weakness of breathing muscles can affect the ability to breathe normally and may require emergency treatment
Severe swallowing weakness	Difficulty swallowing can increase the risk of choking or food entering the lungs
Aspiration-related complications	Food or liquids entering the lungs can lead to breathing problems or infections
Severe respiratory weakness during infection	Infections may worsen muscle weakness and increase breathing difficulties

How are Myasthenia Gravis Symptoms Diagnosed?

Doctors evaluate myasthenia gravis symptoms by reviewing medical history, examining muscle strength, and using specific tests to assess nerve-muscle communication. The table below explains the common diagnostic tests used to evaluate myasthenia gravis symptoms:

Diagnostic Test	Purpose
Medical and neurological examination	Assesses muscle strength and identifies patterns of weakness
Acetylcholine receptor (AChR) antibody test	Detects antibodies that affect communication between nerves and muscles
Muscle-Specific Kinase (MuSK) antibody test	Checks for antibodies linked with muscle-specific kinase-related myasthenia gravis
Repetitive nerve stimulation	Evaluates changes in muscle response after repeated nerve stimulation
Single-fibre electromyography (EMG)	Detects problems with nerve-muscle signal transmission
CT or MRI of the chest	Checks the thymus gland for abnormalities
Pulmonary function tests	Assesses breathing muscle strength

Blood tests do not always spot myasthenia gravis. If standard tests come back clear, doctors can run other specialised blood tests. They can also measure your nerve signals or use a physical exam to confirm the diagnosis.

FAQs

Q1. What is usually the first symptom of myasthenia gravis?

Ans: The first symptoms of myasthenia gravis are often drooping eyelids or double vision.
Q2. Can myasthenia gravis develop without noticeable symptoms?

Ans: Myasthenia gravis symptoms are usually present, but they may be mild or limited to certain muscles. Early symptoms, such as occasional eyelid drooping or double vision, may not always be recognised immediately.
Q3. Which myasthenia gravis symptoms should never be ignored?

Ans: Myasthenia gravis symptoms such as increasing weakness, difficulty swallowing, repeated choking, trouble speaking, or breathing difficulties should be evaluated by a doctor.
Q4. Are myasthenia gravis symptoms different in men and women?

Ans: Myasthenia gravis symptoms are not classified into separate male-specific or female-specific symptoms. The symptoms depend mainly on which muscles are affected and the severity of weakness.
Q5. Can myasthenia gravis affect more than the eyes?

Ans: Yes. Myasthenia gravis can also affect the muscles involved in facial movement, speech, and swallowing, causing symptoms such as facial weakness and generalised muscle weakness.
Q6. When should I see a doctor for myasthenia gravis symptoms?

Ans: You should consult a doctor promptly for myasthenia gravis if you experience persistent or recurring muscle weakness, drooping eyelids, double vision, or difficulty speaking, swallowing, or breathing.
Q7. Can the intensity of myasthenia gravis symptoms vary?

Ans: Yes, the intensity of myasthenia gravis symptoms can vary in patients. They may worsen with tiredness, repeated activity, and other triggers.
Q8. When do myasthenia gravis symptoms require emergency care?

Ans: Myasthenia gravis symptoms such as severe breathing difficulty, inability to swallow, or rapidly worsening weakness may indicate a medical emergency.