Presentation of Myasthenia Gravis (MG)

Opinion
Video

Expert neurologists discuss the presentation of myasthenia gravis (MG), focusing on the variability of symptoms from patient to patient.

This is a video synopsis/summary of a panel discussion involving James Howard, MD; Nicholas Silvestri, MD, FAAN; Tuan Vu, MD; Ali Habib, MD; and Beth Stein, MD.

The discussion revolves around the variability in presentation of myasthenia gravis (MG), emphasizing personalized care and treatment selection. MG typically manifests with ocular symptoms such as double vision and droopy eyelids, or bulbar symptoms affecting swallowing, speaking, and chewing. However, presentations vary widely; some patients exhibit proximal muscle weakness while others experience predominantly distal weakness. Additionally, the presence or absence of ocular symptoms can complicate diagnosis.

In clinical practice, ocular onset followed by secondary generalization is common. However, some patients present with limb or respiratory onset, posing diagnostic challenges, especially when respiratory failure occurs. The transition from ocular to generalized symptoms typically occurs within the first 2 years of diagnosis, emphasizing the importance of early intervention to prevent respiratory compromise and hospitalization. While most patients generalize within this timeframe, exceptions exist, as illustrated by a case where ocular disease persisted for over a decade before progressing following a flu-like illness.

Understanding the diverse presentations of MG underscores the need for individualized treatment approaches tailored to each patient's symptoms and disease trajectory. By recognizing and addressing variability in presentation, clinicians can optimize outcomes and improve patient care in MG management.

Video synopsis is AI-generated and reviewed by NeurologyLive editorial staff.

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