Myasthenia gravis is diagnosed from fatigable weakness that worsens with use and improves with rest, confirmed by antibody blood tests and by specialised electrodiagnostic studies. Drooping eyelids and double vision that worsen through the day are the classic presentation.
Myasthenia gravis is diagnosed from fatigable weakness that worsens with use and improves with rest, confirmed by antibody blood tests and by specialised electrodiagnostic studies. Drooping eyelids and double vision that worsen through the day are the classic presentation.
The distinguishing feature is weakness that gets worse the more a muscle is used and recovers with rest. That produces a characteristic daily pattern: symptoms mild in the morning and worse by evening. Most people present with eye involvement, meaning a drooping eyelid or double vision, and in many the disease later generalises to involve the limbs, speech, chewing or swallowing. Examination looks specifically for fatigability, for instance whether an eyelid droops further on sustained upward gaze.
Antibodies against the acetylcholine receptor are found in most people with generalised myasthenia gravis, and testing for MuSK antibodies is used when those are negative. A proportion are seronegative on both, so a negative antibody result does not exclude the diagnosis. Specialised electrodiagnostic studies, repetitive nerve stimulation and single-fibre techniques, demonstrate the failure of neuromuscular transmission directly. Electrodiagnostic testing is performed at both CNS offices in AANEM-accredited laboratories.
Imaging of the chest is arranged, because a proportion of patients have a thymoma and identifying it changes management. Thyroid function is checked, since autoimmune thyroid disease commonly coexists. The urgent consideration is respiratory: weakness affecting breathing or swallowing is a medical emergency and needs hospital assessment immediately rather than an outpatient appointment. Certain medications, including some antibiotics and magnesium, can worsen myasthenia markedly and should be reviewed.
Clinical Neurology Specialists has been physician-owned since 1998, when Leo Germin, M.D., FAANEM founded it. Five board-certified neurologists and four advanced practice providers see patients at the Las Vegas and Henderson offices, each with its own AANEM-accredited electrodiagnostic laboratory.
Clinical Neurology Specialists is an adult outpatient neurology practice for patients 18 and older. The practice performs no surgery and operates no imaging suite, infusion suite or interventional pain programme, and provides no emergency or inpatient care.
Physician-reviewed. Reviewed by the physicians of Clinical Neurology Specialists — board-certified neurologists, AANEM-accredited electrodiagnostic laboratories, physician-owned since 1998. Reviewed 1 August 2026. This article is general education for adults 18 and older and is not a substitute for a consultation.
Adults 18 and older, at the Las Vegas and Henderson offices. Call 702-804-1212 or request an appointment online.