What should I do if myasthenia gravis causes difficulty swallowing?

Written by Shi De Quan
Neurology
Updated on May 28, 2025
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Myasthenia gravis primarily manifests as an inability to swallow, affecting the pharyngeal muscles or the muscles involved in swallowing. Thus, difficulty in swallowing is also a symptom of myasthenia gravis. At this time, the main treatment should focus on the primary disease, administering medications such as neostigmine for myasthenia gravis, and using steroids or immunosuppressants in severe cases. If there is difficulty in swallowing, or if it persists for more than two or three days, a gastric tube can be inserted for nasal feeding to maintain nutrition. Then, as the symptoms of myasthenia gravis subside with medication, swallowing function can recover.

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Myasthenia gravis initial symptoms

Myasthenia gravis is characterized by fluctuating and fatigue-prone muscle weakness in certain specific striated muscles. Symptoms are generally milder in the morning and more severe in the evening, worsening with continued activity and alleviating after rest. The most common initial symptom is weakness of the external eye muscles, primarily presenting as asymmetrical ptosis (drooping of the upper eyelid) or narrowing of the eye slit, along with diplopia, which refers to seeing double images. These are the most frequent initial symptoms, seen in over 50% of patients with myasthenia gravis. Additionally, some patients may experience disturbances in eye movement, facial muscle weakness, air leakage when puffing cheeks, incomplete eyelid closure, shallower nasolabial folds, as well as difficulty swallowing, speech articulation issues, choking while drinking, and potentially severe respiratory weakness.

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Myasthenia gravis should be seen in the Neurology department.

Patients with myasthenia gravis should consult the department of neurology, as myasthenia gravis is an immune-related neuromuscular junction disorder. Patients often exhibit pathological fatigue, skeletal muscle involvement, and unaffected smooth muscles. The most common type is ocular myasthenia, followed by mild and moderate generalized forms. Adult patients often have thymomas or thymic hyperplasia. Upon diagnosis of myasthenia gravis, it is essential to perform a comprehensive thymic CT scan. If thymic abnormalities are present, referral to thoracic surgery for treatment is needed. If there is no thymic disease, high-dose steroid pulse therapy may be considered. Additionally, it is crucial to determine whether the patient has other coexisting immune abnormalities, such as hyperthyroidism or connective tissue disease, and tailor the treatment accordingly.

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Does myasthenia gravis cause sensitivity to cold?

Patients with myasthenia gravis tend to be sensitive to cold, mainly due to the following factors: Firstly, patients with myasthenia gravis generally experience overall weakness and have very limited physical activity, making their physique rather frail. Patients with a weak physique are definitely more susceptible to colder environments. Secondly, patients with myasthenia gravis have lower resistance to diseases and often take immunosuppressants for a long time, making them highly susceptible to respiratory and lung infections. In cold conditions, some viruses can exploit this weakness, leading to exacerbated lung and respiratory infections, which is another major reason why patients with myasthenia gravis are sensitive to cold. Thirdly, myasthenia gravis is an autoimmune disease that leads to immune dysfunction. This immune dysfunction makes patients particularly sensitive to cold stimuli. In a cold environment, their immune function may become even more disordered, contributing further to their sensitivity to cold.

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Is myasthenia gravis an autoimmune disease?

Myasthenia gravis is an autoimmune disease that primarily affects the neuromuscular junction, leading to abnormalities in acetylcholine receptors. This can cause weakness in some or all skeletal muscles, which easily fatigues, particularly after activity or exertion, with symptoms worsening. Symptoms can be alleviated after rest or treatment with cholinesterase inhibitors. As an autoimmune disease, myasthenia gravis often co-occurs with other autoimmune disorders such as hyperthyroidism, thyroiditis, systemic lupus erythematosus, and rheumatoid arthritis. Symptoms of myasthenia gravis typically lessen in the morning and worsen after activity, showing a pattern of being lighter in the morning and heavier in the evening.

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Will severe myasthenia gravis swallowing difficulties improve?

Myasthenia gravis and difficulty swallowing generally improve with medication treatment. Myasthenia gravis is a neuromuscular disease that typically presents with worsened muscle weakness and swallowing difficulties during fatigue. This condition requires targeted pharmacological treatment and further repetitive stimulation, which can involve specific medications and steroids. Swallowing difficulties associated with myasthenia gravis are typical of generalized myasthenia gravis, necessitating active pharmaceutical treatment, which usually has good outcomes. Avoid overworking, staying up too late, smoking, and excessive drinking. It is important to rest sufficiently, ensure ample sleep, eat fresh vegetables and fruits, and consume high-protein, nutritious foods.