Last reviewed: 4 Feb 2021
Last updated: 23 Oct 2018



History and exam

Key diagnostic factors

  • muscle fatigability
  • ptosis
  • diplopia
  • dysphagia
  • dysarthria
  • facial paresis
  • proximal limb weakness
  • shortness of breath

Risk factors

  • FHx of autoimmune disorders
  • genetic markers
  • cancer-targeted therapy

Diagnostic investigations

1st investigations to order

  • serum acetylcholine receptor (AChR) antibody analysis
  • muscle-specific tyrosine kinase (MuSK) antibodies
  • serial pulmonary function tests

Investigations to consider

  • striational antibodies
  • repetitive nerve stimulation
  • single-fiber EMG
  • CT of chest

Treatment algorithm


Parker Webber Chair in Neurology

Professor of Neurology

Professor of Immunology and Microbiology

Wayne State University School of Medicine




RPL is an unpaid member of the Medical Advisory Committee and the Research Committee of the Myasthenia Gravis Foundation of America. He has consulted for Gerson Lehman Group, in the form of two 1-hour conversations with clients of GLG on the state of current treatments in MG.

Dr Robert Lisak would like to gratefully acknowledge Dr Andrea Corse and Dr Ami Mankodi, previous contributors to this monograph. AC and AM declare that they have no competing interests.

Peer reviewersVIEW ALL

Associate Professor of Medicine (Neurology)

Duke University




VCJ declares that he has no competing interests.

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