Myasthenia gravis literally means severe weakness; the name is derived from the observation that approximately one-third of all patients prior to 1960 died of direct complications of their illness. Initially a fatigue syndrome, the illness evolves to ptosis, diplopia, dysphagia, and dysarthria, shortness of breath, and ultimately respiratory insufficiency. Proximal weakness in the shoulder girdles, particularly of the deltoid, and in the hip girdle muscles, particularly of the iliopsoas, is ultimately prominent. Muscle atrophy is unusual except in long-standing severe cases with duration of more than two decades.
KeywordsPlacebo Fatigue Toxicity Creatinine Corticosteroid
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