Understanding Myasthenia Gravis: Insights From Our Neurologist
08 December 2025
Find yourself experiencing muscle weakness and fatigue that interferes with basic tasks like opening doors and holding objects, accompanied by other issues like double vision and droopy eyelids?
These signs may be linked to myasthenia gravis, a rare neuromuscular autoimmune disorder that isn’t widely known but can be debilitating and significantly affect daily life.
To help raise awareness of this condition, we spoke with Consultant Neurologist, Dr Hiew Fu Leong, who shared insights into this disorder, which can affect both children and adults.
What Is Myasthenia Gravis?
Myasthenia gravis is a rare autoimmune disorder that affects the connection between nerves and muscles, which is known as the neuromuscular junction. When this connection is disrupted, muscles cannot receive proper signals, causing them to become weak and easily fatigued.
According to Dr Hiew, this happens because the body’s own immune system mistakenly attacks receptors responsible for transmitting signals to the muscles. As a result, simple activities that require muscle strength, such as chewing, speaking or lifting, can become unexpectedly difficult.
This condition affects people of all ages. Women commonly develop the disorder before age 50, while men typically develop it after age 50.
Common Symptoms of Myasthenia Gravis
Myasthenia gravis can affect people differently. A hallmark symptom of this autoimmune disease is muscle weakness that worsens with activity and improves with rest.
Other common symptoms include:
- Weakness in the arms, legs, or neck
- Lower face weakness
- Drooping eyelids (ptosis)
- Blurred or double vision
- Difficulty speaking, chewing, or swallowing
- Shortness of breath, especially in more severe cases
Because these symptoms are similar to those of stress, fatigue, or other conditions, early signs of myasthenia gravis often go unnoticed.
How It Is Diagnosed
To diagnose myasthenia gravis, doctors typically perform imaging and blood antibody tests, and specialised neurophysiological assessments. These may include:
- Repetitive Nerve Stimulation (RNS): A test where small electrical shocks are applied to a nerve to assess muscle response.
- Single-Fibre Electromyography (SFEMG): A diagnostic test where a fine needle into the muscle to measure its electrical activity.
- Ice-Pack Test: A bedside test where ice is applied to the eyes for 2 to 5 minutes to assess improvement in drooping eyelids.
- Simpson Test: For this test, the patient is asked to gaze upward for 1 to 2 minutes to observe for drooping eyelids.
- Rest Test: During this test, the patient lies quietly in a dark room with eyes closed for 5 minutes to determine if eyelid symptoms improve.
Why Early Detection Matters
Dr Hiew emphasises that recognising myasthenia gravis early is essential. If left untreated, the disease can progress and cause severe weakness of the respiratory muscles, also known as a myasthenic crisis.
This is a medical emergency that requires intensive care unit (ICU) care and ventilator support.
However, myasthenia gravis patients do not have to live in fear of this outcome.
“With early diagnosis and proper treatment, most individuals with myasthenia gravis can live normal or near-normal lives,” shared Dr Hiew.
He added that many of his patients are able to manage their symptoms effectively through medications, therapies, lifestyle adjustments, and, in some cases, surgery.
The impact of myasthenia gravis is real, but early diagnosis can make a significant difference. If you notice persistent muscle weakness, visual disturbances or unexplained fatigue in yourself or a loved one, do not ignore the warning signs.
Seek prompt evaluation and medical care with our Consultant Neurologist, Dr Hiew Fu Leong, by scheduling an appointment now
