Class IV: Severe weakness affecting muscles other than ocular muscles; may also have ocular muscle weakness of any severity. A. IVa. Predominantly affecting limb, axial muscles, or both.

The MGFA classification has some subjectivity in it when it comes to distinguishing mild (Class II) from moderate (Class III) and moderate (Class III) from severe (Class IV).

Myasthenia gravis is an autoimmune disease that’s categorized as a type II hypersensitivity that involves autoantibodies binding acetylcholine receptors on skeletal muscle cells.

The MGFA mission is to facilitate the timely diagnosis and optimal care of individuals affected by myasthenia gravis and closely related disorders and to improve their lives through programs of patient services, public information, medical research, professional education, advocacy and patient care.

The hallmark of myasthenia gravis is muscle weakness that worsens after periods of activity and improves after periods of rest. Certain muscles such as those that control eye and eyelid movement, facial expression, chewing, talking, and swallowing are often (but not always) involved in the disorder.

The quantitative myasthenia gravis score (QMG) (ta- ble 1) was developed as a tool for assessing the unique pattern of deficits in patients with MG.

The MG-ADL is an eight-question survey of symptom severity, with each response graded from 0 (normal) to 3 (most severe). Two questions concern ocular, three oropharyngeal, one respiratory, and two extremity functions (figure 2). Cumulative MG-ADL scores range from 0 to 24.

MG may present as unilateral ptosis or facial drooping without the hallmark characteristic of fluctuating muscle weakness. Early diagnosis and subsequent treatment of MG improves long term prognosis and remission rates.

Nerve tests If your blood test result is normal but the doctor still thinks you could have myasthenia gravis, they may suggest an electrical test of your nerves and muscles. These tests, known as electromyography, involve inserting very small needles into your muscles to measure the electrical activity in them.

The QMG is a 13-item direct physician assessment scoring system that quantifies disease severity based on impairments of body functions and structures. Each item is quantitatively assessed and scored from 0 to 3 (where 3 represents the most severe), providing a total QMG score ranging from 0 to 39.