Fatigue is an important symptom of myasthenia gravis (MG) that makes a patients’ quality of life worse, according to a new study published in Acta Neurologica Belgica. Fatigue can be seen independently of muscle weakness in these patients.

Fatigue and muscle weakness are the hallmarks of MG. However, the perception of fatigue and its effect of this on patients’ quality of life has not been extensively studied.

Here, a team of researchers from the Department of Neurology at Marmara University School of Medicine in Istanbul, Turkey led by Tulin Tanridag, MD, evaluated fatigue frequency in patients with MG who nearly had full muscle strength. The researchers also assessed the effect of this fatigue on patients’ quality of life.

The team used the Myasthenia Gravis Composite (MGC) scale and Myasthenia Gravis Activities of Daily Living (MG-ADL) profile to measure the severity of the disease and quality of life in 53 patients with ocular or mild generalized MG.

Read more about the symptoms of MG

They also used the Fatigue Assessment Scale (FAS) and Fatigue Impact Scale (FIS), Beck Depression Inventory (BDI), and Epworth Sleepiness Scale to assess fatigue, depression, and sleep, respectively, in both the patients 53 healthy volunteers. Finally, they used the Myasthenia Gravis Foundation of America (MGFA) and MGFA Post-Intervention Status classifications to assess disease severity.

The results showed that the scores for FAS, FIS physical, and BDI were significantly higher in patients with MG than in healthy controls. Moreover, fatigue was associated with depression and daytime sleepiness, which were higher in female patients. The mean values of FIS total and cognitive scores were higher among patients with generalized MG and fatigue scores correlated with motor signs.

“Fatigue can be seen in MG independently from muscle weakness and is an important symptom worsening the quality of life,” the researchers concluded.


Akkan Suzan A, Kahraman Koytak P, Uluc K, Tanridag T. Physical and mental fatigue in myasthenia gravis and its correlation with other symptoms. Acta Neurol Belg. Published online March 25, 2022. doi:10.1007/s13760-022-01919-y