What is Myasthenia Gravis?
Myasthenia gravis (MG) is a chronic autoimmune neuromuscular condition that disrupts communication between nerves and muscles. In people with MG, this signalling process is disrupted, making it harder for muscles to respond. As a result, muscles become weak and tire more easily. MG primarily affects voluntary muscles (those under conscious control) particularly in the face, neck, arms and legs. Everyday functions such as moving the arms and legs, facial expressions, holding the eyes open, breathing, chewing and swallowing can all be affected.
Myasthenia gravis is a rare neurological condition. The Australian Institute of Health and Welfare reported that in 2009, only 2600 people were living with MG in Australia.
There are several types of myasthenia gravis, identified by the underlying cause of the condition or what muscles have been affected. Some of the types include:
Generalised Myasthenia Gravis: This is the most common form of MG. It affects multiple muscle groups throughout the body, and weakness may occur in the arms, legs, face, throat, and sometimes respiratory muscles.
Ocular Myasthenia Gravis: This type of MG is limited to the muscles that control eye movement. It might cause drooping eyelids, blurred or double vision, and difficulty focusing.
Bulbar Myasthenia Gravis: Affects the muscles that control speaking, chewing, swallowing and breathing. Symptoms may be more severe, because respiratory function can be involved. This type of MG can lead to slurred speech, difficulty eating, choking or shortness of breath.
Transient Neonatal Myasthenia Gravis: Occurs in babies born to mothers with MG, where they have passively received MG-related antibodies through the placenta during pregnancy. It is a temporary condition that typically resolves within a few weeks to months but can cause feeding difficulties and low muscle tone (hypotonia).
Congenital Myasthenic Syndromes (Congenital MG): This is a rare, inherited form of MG that is present from birth, caused by genetic mutations that affect neuromuscular function. Unlike transient neonatal MG, babies with congenital MG are born to non-myasthenic mothers and still develop symptoms of MG.
Juvenile Myasthenia Gravis: Affects children and adolescents and can appear as ocular or generalised MG. Symptoms in young people usually begin with weakness in the eye or facial muscles.
Seronegative Myasthenia Gravis: In seronegative myasthenia gravis, routine blood tests don’t pick up the usual antibodies doctors look for. Even so, people still experience the typical symptoms of MG. Because the blood test doesn’t show the antibodies, doctors rely more on examining symptoms and using nerve and muscle tests to make the diagnosis.
Recognising and Diagnosing Myasthenia Gravis
As the symptoms of MG can be present with many other medical conditions, diagnosis can be difficult – especially in mild cases. Common symptoms can include:
- Drooping eyelids (ptosis)
- Double vision (diplopia)
- Difficulty speaking, chewing or swallowing
- Limb and neck weakness
- Breathlessness in more severe cases
- Fatigue that improves after rest
There is no single test that offers a definitive diagnosis of MG. Rather a patient may present to their GP and then be given a referral to a neurologist, ophthalmologist or immunologist for further investigation. Specialists may then use a combination of medical history, physical and neurological examination, antibody blood tests and nerve tests to make a diagnosis and rule out other conditions. While waiting for a diagnosis, the Neurological Council’s NeuroCare Community Neurological Nursing service offers compassionate support, helping individuals and their families feel informed, supported, and less alone during an often stressful and uncertain time.
Sometimes, treatment for MG might be trialled to help clarify the diagnosis if there are doubts about whether what the patient is experiencing is MG or another condition.
What Causes Myasthenia Gravis?
MG is considered to be an autoimmune disorder that acts as a neurological (neuromuscular) disease; however, the exact cause is not fully known. Our bodies use a chemical messenger called acetylcholine[AF2] (ACh) to help our nerves talk to our muscles, telling them when to move. For those with Myasthenia Gravis, the immune system creates antibodies that block or damage the acetylcholine receptors on the muscle, so the message doesn’t get through properly. This is what causes muscle weakness and fatigue. Many MG treatments work by reducing or controlling these antibodies so that more acetylcholine can reach the muscle and the signals can pass through more normally.
The trigger of these autoimmune attacks is unknown, but there may be a connection to certain viral or bacterial proteins that mimic other normal proteins within the body.
There may also be a connection between the thymus (a gland in the chest that plays an important role in the immune system) and MG. It is reported that up to 15% of people with MG have a thymoma (a tumour on the thymus) and up to 65% have an overactive thymus. [AF3]
Treating and Managing Myasthenia Gravis
While myasthenia gravis can look different for everyone, there are effective ways to manage symptoms and support day‑to‑day life. A great first step is visiting your GP, who can help arrange a referral to a neurologist experienced in diagnosing and treating MG.
From before diagnosis and throughout living with MG, the Neurological Council’s NeuroCare service provides ongoing neurological nursing support, information, and care navigation, supporting individuals and carers to understand medical advice, coordinate care, access appropriate services and supports, and manage the practical and emotional impacts of MG over time.
While there is no ‘cure’ for MG, there are several treatment paths to help manage symptoms and improve quality of life:
- Immunosuppressant therapy: Using drugs to suppress the body’s immune system and production of ACh receptor antibodies, which allows the receptors to regenerate and function more effectively to promote better muscle strength.
- Anticholinesterase therapy: Using drugs to boost neurotransmitter ACh, by blocking the enzyme that breaks down ACh.
- Plasmapheresis: Where blood is taken out of the body, the acetylcholine receptor antibodies are removed and the blood is then returned to the body.
- Thymectomy: When the thymus gland is surgically removed.
- Lifestyle changes: Getting enough rest and minimising physical activity can be helpful for managing MG symptoms.
Supporting Someone with Myasthenia Gravis
While care from a GP or neurologist is essential in managing myasthenia gravis, many people also benefit from additional supports, including the Neurological Council’s NeuroCare service, alongside the support of family, friends and carers.
Muscle weakness, fatigue, breathing difficulties, and problems with speech and swallowing can significantly affect quality of life. Symptoms may limit a person’s ability to eat, work, drive, socialise, or manage everyday tasks such as shopping, cooking and household chores. Coordinating medical appointments and ongoing treatment, alongside daily responsibilities, can also place considerable pressure on family members and carers.
If you are supporting someone living with myasthenia gravis, you may find it helpful to read our article offering practical, real-world advice for people caring for someone with a neurological condition.
The Importance of Peer Support
Peer support plays an important role for people living with MG by providing opportunities to connect with others who share similar experiences. These connections can offer practical insights, reassurance, and a sense of belonging that complements clinical and community based care. The Neurological Council’s NeuFriends Neurological Support Groups provide a safe and welcoming environment for people impacted by neurological conditions to connect with one another, with additional support and guidance available from NeuroCare nurses.
Research and further reading
Ongoing research continues to improve understanding of myasthenia gravis and its treatment. For those interested in the latest research and clinical developments, the following sources provide regularly updated, reliable information:
Myasthenia Alliance Australia: Research updates
Myasthenia Alliance Australia: Latest research
Where to Get Information and Support
- Myasthenia Alliance Australia
- Helpline: 1800 802 568
- Website
- Myasthenia Gravis Association in NSW (MGNSW)
- Myasthenia Gravis Association of Queensland Inc.
- NeuroCare TeleNurse Helpline: 1800 645 771
Find your closest NeuFriends Neurological Support Group