Myasthenia gravis history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
History
Common symptoms
The hallmark of myasthenia gravis is Fluctuating weakness of specific muscles in limbs, bulbar, ocular and respiratory system which get worse with activity or using the muscle.(1-2 clinical va 63 symptom asli) Symptoms of myasthenia gravis include:
ptosis and diplopia
About 50 percent of patiens have ptosis and diplopia as their presenting sign. Ptosis is usually asymmetrical. The direction and degree of diplopia may change in a MG patients because of fatigable ocular motor paresis.(10 uptodate ocular)
Gaze paralysis
The ocular muscle weakness in MG can cause gaze paralysis and even mimic internuclear ophthalmoplegia or midline brain lesions.(146 asli)
Photophobia
A lot of patients with myasthenia gravis complain that bright light bothers them and can even worsen the weakness of their eye muscles. Since this symptom is seen even in untreated patients, it’s not a complication of anticholinesterases treatment.(77asli)
Facial weakness
The facial weakness in MG occurs without sensation impairment of face. The sensation problems along with facial weakness suggest a different diagnosis like nasopharyngeal carcinomas.(113asli)
Orbicularis oculi weakness
If we try to keep the upper eyelid of a MG patient open, they cannot close it against our force because of the weakness of orbicularis oculi muscle.(121asli)
tongue weakness, chewing problems and dysphagia
The muscles of the tongue will become weak in MG patients especially after long speech. This can lead to unintelligible speech and dysphasia. Difficulty in swallowing can cause choking and nasal regurgitation. Furthermore the weakness of mastication muscles will cause chewing problem and can lead to weight loss.(1-2-3 tongue)
Respiratory problems
Inability to maintain a patent airway or respiratory insufficiency can occur in MG patients especially those who are in the MG crises.(67 asli) Respiratory problems can cause inadequate sleep and day time somnolence.(68asli)