Myasthenia Gravis
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.
