Can External Trauma Trigger Myasthenia Gravis Symptoms Immediately? - Rare Disease

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Myasthenia Gravis


Hello Dr.
Chen: I hope it's not too presumptuous to ask you a few questions.
Is it possible for myasthenia gravis to be triggered by external forces or stress caused by trauma (such as a car accident, impact injury, or falls)? Can it manifest immediately? Is it possible for symptoms such as diplopia and ptosis to appear right away? I would greatly appreciate your insights.
Thank you.
He Hongtai 093005232502-26943548

He, 40~49 year old female. Ask Date: 2004/08/03

Dr. Chen Shunsheng reply Rare Disease


Myasthenia gravis is primarily caused by anti-acetylcholine receptor antibodies, which damage the post-synaptic cleft acetylcholine receptors at the neuromuscular junction of skeletal (striated) muscles, leading to muscle fatigue and weakness.
This condition is unrelated to external forces or trauma.
The presence of these antibodies is associated with thymoma or thymic lymphoid hyperplasia, resulting in approximately one-third of myasthenia gravis patients having thymomas and half exhibiting thymic lymphoid hyperplasia and enlargement.
Myasthenia gravis most commonly and early affects the ocular muscles, causing ptosis (drooping eyelids) or ocular muscle paresis leading to diplopia (double vision).
The next most affected muscles are those controlled by the motor nuclei in the pons and medulla (also known as the bulbar nuclei), including the muscles for mastication, swallowing, and respiration.
Following that, limb muscles are affected.
The involved muscles often exhibit lymphocytic inflammatory responses and may even show muscle fiber atrophy.

Reply Date: 2004/08/03

More Info


Myasthenia Gravis (MG) is an autoimmune neuromuscular disorder characterized by weakness and rapid fatigue of voluntary muscles. It occurs when the immune system mistakenly attacks the communication between nerves and muscles, specifically at the neuromuscular junction. The symptoms of MG can vary widely among individuals, but common manifestations include muscle weakness, double vision (diplopia), drooping eyelids (ptosis), and difficulty swallowing or speaking.

Regarding your question about whether external trauma can trigger Myasthenia Gravis symptoms immediately, the answer is nuanced. While there is no direct evidence that trauma such as a car accident or a fall can cause Myasthenia Gravis, it is important to understand that stressors, including physical trauma, can exacerbate existing conditions or potentially trigger symptoms in individuals who are predisposed to autoimmune disorders.

1. Immediate Onset of Symptoms: In general, Myasthenia Gravis does not present symptoms immediately following trauma. The onset of MG is typically gradual, with symptoms developing over weeks or months. However, in some cases, physical stress or trauma may lead to a temporary worsening of muscle strength in someone who already has MG, or it may unmask underlying neuromuscular issues that were previously asymptomatic.

2. Symptoms Following Trauma: If an individual experiences symptoms such as double vision or drooping eyelids immediately after trauma, it is more likely that these symptoms are related to the trauma itself rather than the onset of Myasthenia Gravis. For example, trauma can cause direct injury to the muscles or nerves, leading to temporary weakness or dysfunction. Additionally, conditions such as concussion or other neurological injuries can also present with similar symptoms.

3. Diagnosis and Evaluation: If you or someone else is experiencing symptoms like diplopia or ptosis after a traumatic event, it is crucial to seek medical evaluation. A healthcare provider can perform a thorough examination, including neurological assessments and possibly tests such as electromyography (EMG) or blood tests for antibodies associated with Myasthenia Gravis. These evaluations can help determine the underlying cause of the symptoms and whether they are related to MG or another condition.

4. Management of Symptoms: If Myasthenia Gravis is diagnosed, treatment options may include medications such as anticholinesterase agents (e.g., pyridostigmine), immunosuppressants, or therapies like plasmapheresis or intravenous immunoglobulin (IVIG) for severe cases. Managing stress and avoiding known triggers is also important for individuals with MG.

In summary, while external trauma is not a recognized cause of Myasthenia Gravis, it can potentially exacerbate symptoms in individuals with the condition or lead to similar symptoms due to other causes. If you are experiencing concerning symptoms, it is essential to consult with a healthcare professional for a comprehensive evaluation and appropriate management.

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