Myasthenia gravis is a condition that causes muscle weakness due to a breakdown in communication between nerves and muscles. The symptoms can vary widely but generally involve muscles becoming weak and tiring quickly, especially after use, and often improving with rest.
One of the earliest and most common signs involves the **eye muscles**. More than half of people with myasthenia gravis first notice problems like **drooping eyelids (ptosis)** or **double vision (diplopia)**. The double vision can affect horizontal or vertical sight and may improve if one eye is closed. These eye symptoms often fluctuate, worsening with activity and improving after rest.
Another group of symptoms affects the **face and throat muscles**. About 15% of people experience early difficulties here. This can include:
– **Speech problems**, where the voice may sound soft, nasal, or slurred because the muscles controlling speech get tired.
– **Swallowing difficulties**, which can cause choking or make it hard to eat, drink, or take pills. Sometimes liquids may even come out of the nose due to weak throat muscles.
– **Chewing fatigue**, especially noticeable when eating tough foods like steak, where the jaw muscles tire halfway through a meal.
– **Facial expression weakness**, making it hard to fully raise eyebrows, smile, or show emotions clearly because the muscles tire quickly.
As the condition progresses, **neck and limb muscles** can become weak. Weakness in the neck muscles may make it difficult to hold up the head, while weakness in the arms and legs can affect walking and the ability to use the hands and arms effectively.
In more severe cases, muscles involved in **breathing** can be affected, which is a medical emergency requiring immediate attention. Difficulty breathing or shortness of breath can signal a myasthenic crisis, where the respiratory muscles become too weak to function properly.
A key feature of myasthenia gravis symptoms is that they **worsen with activity and improve with rest**. For example, a person might feel strong in the morning but experience increasing weakness as the day goes on. Heat, stress, illness, and exercise can also make symptoms worse.
Other symptoms that may appear include:
– **Blurred vision** alongside double vision.
– Generalized muscle weakness beyond the eyes and face, affecting the arms, legs, and trunk.
– Fatigue that is not relieved by sleep but improves with muscle rest.
– Difficulty holding up the head due to neck muscle weakness.
– Problems with fine motor skills due to hand and arm weakness.
Because myasthenia gravis affects muscles variably and symptoms can fluctuate, it can sometimes be mistaken for other conditions. The weakness is typically painless but can be disabling, especially when it affects swallowing, speaking, or breathing.
People with myasthenia gravis may notice that their symptoms come and go, sometimes improving for a while before worsening again. The disease often progresses over the first one to three years before stabilizing, but the pattern can differ from person to person.
If someone experiences any of the following, they should seek medical advice promptly:
– Persistent or worsening drooping eyelids or double vision.
– Difficulty swallowing or chewing.
– Slurred or soft speech.
– Weakness in the arms, legs, or neck.
– Trouble breathing or shortness of breath.
Understanding these symptoms is crucial because early diagnosis and treatment can help manage the condition effectively and improve quality of life. Myasthenia gravis is a lifelong condition, but with proper care, many people can maintain good muscle function and lead active lives.
