Myasthenia Gravis

16 June 2025

Overview

Myasthenia Gravis (MG) is a chronic autoimmune neuromuscular disorder that causes weakness in the skeletal muscles, which are responsible for breathing and moving parts of the body. At Royal Buckinghamshire Hospital, we offer advanced diagnostics, treatment options, and in-patient neurological rehabilitation to help manage and improve quality of life for people living with MG.

Causes of Myasthenia Gravis

Myasthenia Gravis occurs when the immune system produces antibodies that block or destroy acetylcholine receptors at the junction between nerve and muscle, preventing muscle contraction. The exact trigger is unknown, but it is often associated with:

Autoimmune conditions
Thymus gland abnormalities (e.g. thymoma)
Genetic predisposition

Symptoms of Myasthenia Gravis

Symptoms typically fluctuate throughout the day and may worsen with activity:

Muscle weakness that improves with rest
Drooping eyelids (ptosis)
Double vision (diplopia)
Difficulty speaking (dysarthria)
Difficulty swallowing (dysphagia)
Weakness in the arms, legs, or neck
Breathing difficulties in severe cases (myasthenic crisis)

Diagnosis

A comprehensive diagnostic process includes:

Neurological examination to assess muscle strength and reflexes
Antibody blood tests (e.g. AChR or MuSK antibodies)
Electromyography (EMG) to detect impaired nerve-to-muscle communication
Imaging (CT or MRI) of the chest to check for thymus abnormalities
Tensilon (edrophonium) test in some cases

Treatment Options

Treatment aims to reduce symptoms and control the immune response:

Acetylcholinesterase inhibitors (e.g. pyridostigmine) to improve communication between nerves and muscles
Immunosuppressants such as corticosteroids or other agents
Plasmapheresis or IVIG for rapid symptom relief during a crisis
Thymectomy (surgical removal of the thymus) when a tumour is present
In-patient Neurorehabilitation at Royal Buckinghamshire Hospital, including tailored physiotherapy, speech and swallowing therapy, and fatigue management strategies