Myasthenia gravis (MG) shows up differently for everyone. Even people with the same subtype may experience different symptoms or challenges.
For some it starts with drooping eyelids, double vision or blurred vision. For others, it may be fatigue or muscle weakness. Learning about the types of MG can give you a clearer picture of how symptoms develop and impact the body. Recognizing these differences may help you notice new or changing symptoms sooner. Building this knowledge may also support more meaningful conversations with your healthcare team. Read on to learn more about the different types of MG.
The role of antibodies in MG
MG is caused by autoantibodies that affect the communication between nerves and muscles. Healthcare providers use special blood tests to detect different types of autoantibodies associated with MG, when present in the body. Each MG subtype is named after the part of the nerve muscle connection that the immune system attacks. Those receptors help nerves send signals to muscles, but in MG, the immune system makes autoantibodies that attack certain receptors. This disrupts nerve signals and causes muscle weakness and other symptoms.
MG antibody subtypes include:
AChR antibody-positive MG (acetylcholine receptor antibody-positive MG)- MuSK antibody-positive MG (muscle specific kinase antibody-positive MG)
- LRP4 antibody-positive MG (low-density lipoprotein receptor-related protein 4 antibody-positive MG)
- Triple-seronegative MG (no detectable antibodies)
MG without detectable antibodies
Some people with MG don’t have detectable autoantibodies on standard blood tests. When this happens, this condition is called triple-seronegative MG. People with triple-seronegative MG often face testing delays because their symptoms can be mistaken for stress or mental health challenges. Those with triple-seronegative MG often experience similar symptoms to those with antibody-positive subtypes, but their condition can still act differently and respond differently to treatment.
- Blurred or double vision
- Drooping eyelids
- Limb weakness
- Problems with speaking
- Shortness of breath
- Trouble with chewing or swallowing
When gMG affects the muscles used for breathing or swallowing, it can lead to a myasthenic crisis. This is a medical emergency where severe weakness can make it hard or impossible to breathe on your own. Sometimes the throat muscles become so weak that the airway can be blocked.
- Blurred or double vision
- Drooping eyelids
- Eye fatigue
- Trouble moving eyes
So, what makes the eye muscles more vulnerable in MG? Researchers are still learning more, but one theory is that eye muscles are structurally different from those in the trunk and limbs. These differences may make them more sensitive to the effects of MG.
Even when symptoms are limited to the eyes, regular check-ins with your healthcare team are important. They can help monitor for any changes that might suggest the disease is affecting other muscles.
- Difficulty breathing
- Lack of facial expressions
- Limbs that appear floppy; the baby is too weak to bend their elbows or knees
- Problems with feeding and sucking
- Weak crying
Usually, as the mother’s autoantibodies disappear from the baby’s bloodstream, the baby recovers. It may take a few weeks or months.
JUVENILE MG (JMG)
This rare form of MG begins before age 18. It can affect the muscles in the eyes and eyelids or other muscle groups. Children with JMG may struggle with everyday activities like getting up from the floor, running or climbing stairs. Symptoms often worsen with activity and improve with rest.
Symptoms include:
- Drooping eyelids
- Muscle weakness
- Problems with eating or swallowing
- Shortness of breath
- Weak eye muscles
Explore more resources to better understand MG
Gaining knowledge about the different types of MG can help you better advocate for yourself or a loved one. These insights may also help your healthcare team identify which muscles are involved, inform care decisions and monitor changes over time. Explore the resources below to continue learning and building confidence in managing MG:
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