Myasthenia gravis: an animated, cited guide

This page needs JavaScript for its animations. The outline and key answers are below, and every claim in the full version carries a numbered citation.

Not medical advice. Myasthenia Gravis Companion is an educational synthesis of published literature. It does not replace a clinician.

What is in it

What myasthenia gravis is Who gets it, the numbers, the muscles it reaches.
The neuromuscular junction One nerve impulse in slow motion, and the safety factor.
Antibodies at the junction AChR, complement, MuSK and LRP4, animated.
Weakness over a day Why muscles tire with use and recover with rest.
Diagnosis Antibodies, nerve tests, single-fibre EMG, a calculator.
MGFA class & scores MGFA classes I to V, MG-ADL and QMG, scored live.
The differential Lambert-Eaton, botulism, ALS, eye and muscle disease.
Pyridostigmine, animated Buying time at the receptor, dose by dose.
The treatment ladder From symptom relief to immunotherapy and biologics.
Thymectomy over the years The thymus, thymoma and the MGTX trial.
Complement & FcRn inhibitors The newer biologics, trial week by trial week.
Myasthenic crisis Triggers, the breathing numbers, ICU care.
Drugs that can worsen MG A cited checker: antibiotics, magnesium and more.
Nursing care Assessment, timing the doses, teaching, documentation.
Living with MG Pregnancy, surgery, exercise, vaccines, work.
Toward a cure CAR-T, B-cell targets and the evidence for each route.
History & people From Willis in 1672 to the biologics.
Flashcards, quiz and glossary Revision for students.
Sources Every reference behind the guide.

Part 4 · Crisis, care & the future

Living with MG

Myasthenia gravis through pregnancy, birth and the newborn weeks, then surgery, exercise, vaccines, mood, work and driving. Press play, then pick a topic.

EmergencyAt any stage of life, new or worsening difficulty breathing or swallowing in a person with MG is an emergency: nursing teaching material tells patients to contact the prescriber urgently for these signs. In a newborn of a mother with MG, the signs described are floppiness, poor sucking, swallowing trouble and a weak cry, nearly always within 24 hours of birth, and the guidance asks that every such baby be examined. ^{199,353,410,476}

Pregnancy, birth and the newborn

Planning to six months

Segments are not drawn to the same time scale. Filled dots are published values; the IgG curve between its published anchors, and its fall after birth, are schematic.

Medicines around pregnancy and breastfeeding

What the 2016 international consensus, two reviews by Gilhus and the US labels say. Every choice is made with the treating clinicians; this table only reports what the sources state. ^196,199,476

Medicine	Before and during pregnancy	Breastfeeding

Other parts of life

Pick a topic. The chart grows the published numbers for it, and the panel beside it says what the studies and guidance show, where they disagree, and where no study was found.

Grow the numbers

Questions people bring to a clinic visit

Plain-words prompts built from what the guidance says should be discussed. They are starting points for a conversation, not advice.

If I plan a pregnancy, which of my medicines would need to change, and how far ahead?
Where should I give birth, and will the baby be checked for weakness after birth?
Before an operation, does the anaesthetist know I have MG, and should my pyridostigmine continue?
Which vaccines are right for me on my current treatment, and are any live vaccines a problem?
Who do I tell about double vision and driving where I live?
Is my tiredness the MG, or could it be sleep or mood?

In plain wordsMost people with MG work, exercise and have children. The planning is mostly about medicines, operations and infections.

Where the evidence stops

The commonly quoted Leventhal point weights could not be traced to a primary source, so only the four risk factors are given. ^207,317
No controlled study measuring heat-induced worsening of MG was found. ⁴⁵¹
No MG-specific trial of diet or weight management was found; steroid weight gain is managed with healthy eating and exercise in juvenile MG. ⁴⁰⁰
No US national driving rule specific to MG was found; only the UK DVLA rules are given. ¹⁰⁹
The onset window for neonatal MG often quoted as "up to 3 days" was not found; the source read says weakness nearly always appears within 24 hours. ¹⁹⁹
The succinylcholine 2.6-fold figure is cited through a review, because the original 1988 paper could not be accessed. ⁴⁷