It is important to be constantly mindful of our bodies and how we are feeling, to differentiate between usual fatigue and something more severe, such as a Myasthenia Gravis flare or crisis.
MG Flare (Exacerbation)
A flare is a worsening of usual MG symptoms, but not immediately life-threatening. It is not unusual for women patients to experience more flares during their menstruation period.
What it looks like:
- Increased muscle weakness
- Drooping eyelids (ptosis)
- Double vision
- Slurred speech
- Difficulty chewing or swallowing (mild–moderate)
- Fatigue that worsens through the day
Key point:
👉 Breathing is still adequate (no respiratory failure)
Common triggers:
- Infection (very common)
- Stress, lack of sleep
- Heat
- Certain medications (e.g. some antibiotics)
- Overexertion
- Missed meds
Management:
- Reduce activity levels or activity, and rest
- Hydrate and stay in a cool environment
- Consult your neurologist for possible adjustments to MG medications (e.g. pyridostigmine, steroids)
- Treat underlying trigger (e.g. infection or fever)
- Monitor closely
🔴 MG Crisis (Medical Emergency)
A myasthenic crisis is a severe worsening that affects breathing muscles → life-threatening
What it looks like:
- Severe generalized weakness
- Respiratory distress (shortness of breath, rapid breathing)
- Inability to speak full sentences
- Weak cough → can’t clear secretions
- Trouble swallowing → choking risk
- May require ventilator support
Key point:
👉 Respiratory failure or impending failure
⚠️ The Big Difference
| Feature | MG Flare | MG Crisis |
|---|---|---|
| Severity | Moderate | Severe, life-threatening |
| Breathing | Normal or mildly affected | Compromised |
| ICU needed? | No | Often yes |
| Ventilator | No | May be required |
| Urgency | Urgent | Emergency |
🧠 Important Clinical Insight
A flare can progress into a crisis if:
- It’s not treated early
- There’s infection or pneumonia
- Weakness spreads to respiratory muscles
🚨 When to seek emergency care
If MG patient has:
- Shortness of breath at rest
- Trouble speaking or counting to 20 in one breath
Weak cough or choking
👉 Treat as possible MG crisis. Please proceed to the A&E department of major public or private hospitals immediately.