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Myasthenia Gravis

MG and loss of fine motor skills

02/02/2006

Question:

In the last 6 months I have had problems with movement in my fingers and toes - it is now become very hard to type and walk properly. My neurologist puts this down to my Myasthenia and is getting my physio to electrically stimulate the nerves. Previously any muscle affected by MG was always better with rest, why is this not the case with these muscles. Also I am finding that I am loosing my fine motor skills - can this be put down to myasthenia? This latest set back doesnt seem to be following the pattern of MG but I might be wrong and the Dr is most likely right. So I would appreciate any feedback or information you can give me.

Answer:

I might be hesitant to chalk it up just to the myasthenia. I think of myasthenia as a disease that predominantly affects the big, weight-bearing muscles, what we call proximal muscles. Muscles involved with fine movements are the hand muscles and distal muscles. There are other possibilities, such as concurrent neuropathy from diabetes, thyroid disease, vitamin deficiency, etc. I think of problems that are affecting the distal muscles more when I am thinking about peripheral neuropathies. Pay attention to numbness and tingling sensations that might also suggest this. There are some who theorize that there is a form of myasthenia that affects the distal muscles more than the proximal muscles, but I have yet to see one. An EMG with nerve conduction studies looking for signs of concurrent peripheral neuropathy may be helpful in clarifying this.

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Response by:

Robert W Neel, IV, MD Robert W Neel, IV, MD
Assistant Professor of Neurology
College of Medicine
University of Cincinnati