Myasthenia Gravis
It all begins with an idea.
What is Myasthenia Gravis?
Myasthenia Gravis (MG) is an autoimmune condition that affects the way nerves communicate with muscles, leading to muscle weakness and fatigue. Symptoms often fluctuate — weakness may worsen with activity and improve with rest.
Common symptoms include:
Drooping eyelids or double vision
Slurred speech or difficulty swallowing
Weakness in the arms, legs or neck
Shortness of breath in more severe cases
What Causes It?
In MG, the immune system produces antibodies that disrupt the connection between nerves and muscles at the neuromuscular junction.
These antibodies most commonly target:
The acetylcholine receptor (AChR)
Muscle-specific kinase (MuSK) or LRP4, in some cases
The result is reduced muscle activation and the typical pattern of fluctuating weakness.
How is Myasthenia Gravis Diagnosed?
Diagnosis combines expert clinical assessment with specialist investigations:
Blood tests – to detect AChR, MuSK or LRP4 antibodies
Nerve tests – such as repetitive nerve stimulation or single-fibre EMG
Imaging – CT or MRI scans of the chest to look for a thymoma (a tumour of the thymus gland)
Response to treatment – improvement after specific medications can support the diagnosis
Treatment Options
Treatment is always individualised. The goal is to restore muscle strength, control symptoms, and reduce the underlying immune activity.
Standard therapies include:
Pyridostigmine to improve nerve-muscle communication
Steroids and immunosuppressants (e.g. prednisolone, azathioprine, mycophenolate)
Plasma exchange or intravenous immunoglobulin (IVIg) for rapid, short-term improvement
Thymectomy
The thymus gland plays an important role in MG.
If a thymoma (thymus tumour) is found, surgical removal (thymectomy) is essential.
Even without a tumour, thymectomy can improve long-term outcomes and reduce medication needs, particularly in younger patients with AChR-positive MG.
New and Advanced Treatments
Recent years have seen major progress in MG therapy, with targeted biologic treatments now available in specialist centres:
Complement Inhibitors
(e.g. Eculizumab, Ravulizumab, Zilucoplan)
These block the part of the immune system responsible for damaging the neuromuscular junction, offering rapid and sustained improvement in AChR antibody–positive MG.
FcRn Inhibitors
(e.g. Efgartigimod, Rozanolixizumab)
These new drugs accelerate the breakdown of harmful antibodies, leading to symptom improvement within days. They are given by infusion or subcutaneous injection and are well-tolerated.
These therapies mark a new era in MG management, offering effective control even when traditional treatments are insufficient.
Monitoring and Follow-Up
Regular specialist follow-up is essential to:
Track muscle strength and daily function
Optimise treatment plans
Monitor for side effects of immunosuppressive therapy
Review vaccinations and infection-prevention strategies
With the right care, most people with MG can live full, active lives.
Specialist Myasthenia Gravis Care
I provide comprehensive assessment and ongoing management for patients with all forms of Myasthenia Gravis.
My care includes:
Rapid access to diagnostic testing
Personalised treatment plans
Coordination with neuromuscular and surgical teams when thymectomy is needed
Access to new therapies and clinical trials
📞 Book a consultation or contact us for expert advice on diagnosis and treatment of Myasthenia Gravis.
Migraine: More Than Just a Bad Headache
It all begins with an idea.
If you suffer from migraines, you know they are far more debilitating than a typical headache. Migraines are a neurological disorder characterized by severe, throbbing pain often accompanied by nausea, vomiting, and sensitivity to light and sound.
For many migraine sufferers, the pain isn't the only problem—migraines can cause significant disruption to daily life. Attacks can last anywhere from 4 to 72 hours, forcing you to retreat to a quiet, dark room. According to the Migraine Research Foundation, migraines are the 3rd most prevalent illness in the world and cause moderate to severe disability for over 10% of people affected.
What Causes Migraines? While the exact mechanisms are not fully understood, migraines are thought to start with abnormal brain activity that releases inflammatory substances around the nerves and blood vessels of the head. Potential triggers include hormonal changes, stress, lack of sleep, certain foods, changes in weather patterns, and more. Migraines tend to run in families as well.
Treatment Options If you experience frequent migraines, see your doctor or a headache specialist to get an accurate diagnosis and explore treatment options. These may include:
Preventive medications taken daily to reduce frequency of attacks
Acute treatment with pain-relieving and anti-nausea medications during an attack
Lifestyle changes like improved sleep habits, diet adjustments, and stress management
Don't Suffer in Silence Migraines can take an immense physical and emotional toll. If you experience recurrent, disabling headaches, seek medical care and find a treatment plan to get your migraines under better control. While there is no cure yet, many effective therapies are available to help reduce the impact of this debilitating neurological disorder.
You can find more information about migraines here: www.migrainetrust.org
The Many Possible Causes of Dizziness
It all begins with an idea.
If you've ever felt dizzy, you know how unsettling and disorienting that whirling, spinning sensation can be. Dizziness is a common complaint that can arise from many different underlying causes in the body. While usually not a sign of something life-threatening, dizziness can significantly impact your daily activities and quality of life. Let's explore some of the major causes of dizziness.
Cardiac Causes The heart and vascular system play a vital role in supplying oxygen-rich blood to the brain and inner ear, which are key for maintaining balance and equilibrium. Certain cardiac conditions can lead to dizziness or vertigo (a spinning sensation). These include:
Arrhythmias (irregular heart rhythms)
Heart failure
Drop in blood pressure upon standing up (postural hypotension)
Narrowing or blockages of the arteries supplying blood to the brain
If dizziness is accompanied by chest pain, shortness of breath, or other concerning symptoms, it's crucial to seek prompt medical attention as it could signal a heart attack or stroke.
Vestibular Causes The vestibular system in the inner ear is like your body's gyroscope, constantly sending signals to the brain about your head's movements and position. Vestibular disorders that can induce dizziness and vertigo include:
Benign paroxysmal positional vertigo (BPPV): A mechanical issue where calcium particles become dislodged in the inner ear canals.
Meniere's disease: Excessive fluid buildup in the inner ear.
Labyrinthitis: Inflammation of the inner ear, often due to a viral infection.
Vestibular neuritis: Inflammation of the vestibular nerve.
Vestibular Migraine For some, dizziness and vertigo are actually manifestations of a type of migraine called vestibular migraine. People with vestibular migraine often experience vertigo episodes along with headaches, light/sound sensitivity, nausea and vomiting. The vertigo can last anywhere from a few minutes to a few days.