Patients may present to the ED with new onset weakness due to myasthenia gravis (MG). A group that is frequently missed is late-onset MG, which occurs after the age of 50. It is frequently misdiagnosed as a stroke or transient ischemic attach (TIA).
Two cardinal features:
fatiguability: must be distinguished from fatigue.
fluctuation
Bonus pearl: Ocular symptoms are present in up to 85% of patients with MG, with unilateral ptosis or asymmetric bilateral ptosis being the most common presentations.
References
Nicolle MW. Myasthenia Gravis and Lambert-Eaton Myasthenic Syndrome. Continuum. 2016;22(6):1978–2005
