Muscles that control facial expressions may be affected making it difficult to smile. Weakness can make eating unpleasant and tiring and may cause choking. Patients often have nasal-sounding speech and weak neck muscles that give the head a tendency to fall forward or backward. Initial symptoms of myasthenia gravis may include difficulty speaking (dysarthria), difficulty swallowing (dysphagia), drooping eyelids (ptosis), and double vision (diplopia). Myasthenia gravis is a very variable condition with a wide range of severity and different people may experience weakness in different muscle groups. What are the symptoms of myasthenia gravis? Chest x-ray, CT scan or MRI may be performed to examine the thymus gland, because abnormalities of the thymus are often associated with myasthenia gravis.It involves an injection of a drug called Tensilon which temporarily improves muscle strength in people with myasthenia gravis. The ‘Tensilon test’ is often used to diagnose MG.Muscle contractions that become progressively weaker may indicate myasthenia gravis. Electromyography (EMG) uses electrodes to stimulate muscles and evaluate muscle function. The majority of patients have antibodies to one of these proteins and this confirms the diagnosis of myasthenia gravis (see ‘What causes myasthenia gravis?’ below).
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