Anti-MUSK myasthenia gravis (MG): clinical features
Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .
Anti-MUSK myasthenia gravis (MG): clinical features. Anti-MUSK antibodies are present in 30-50% of antibody-negative MG.
Pathology
- Anti-MUSK antibodies are present in 30-50% of antibody-negative MG
- They cause pre-synaptic and post-synaptic dysfunction
- There is no loss of junctional folds
- There is no loss of acetylcholine receptor (AChR) density
- The thymus gland is usually normal but cases of thymoma have been reported
Aetiology
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Genetics
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Facial and bulbar features
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Ocular features
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Generalised features
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Anti-MUSK MG and pregnancy
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Variant presentations
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Reported triggers
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Differential diagnosis: anti-AChR MG
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Differential diagnosis: others
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Double positive MG (DP-MG)
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References
- Wolfe GI, Oh SJ. Clinical phenotype of muscle-specific tyrosine kinase-antibody-positive myasthenia gravis. Ann N Y Acad Sci 2008; 1132:71-75.
- Takahashi H, Kawaguchi N, Ito N, Takamichi H, Kuwabara S. Is tongue atrophy reversible in anti-MUSK myasthenia gravis? Six year observation. JNNP 2010; 81:701-702.
- Sieb JP. Myasthenia gravis: an update for the clinician. Clin Exp Immunol 2014; 175:408-418.
- Morren J, Li Y. Myasthenia gravis with muscle-specific tyrosine kinase (MuSK) antibodies- a narrative review. Muscle Nerve 2018; 58:344-358.
- Banerjee A, Nathoo N, Purdy K, Puznak K, Siddiqi Z, Zochodne DW. Muscle-specific tyrosine kinase-associated myasthenia gravis with microscopic thymoma. Can J Neurol Sci 2023 (Online ahead of print).
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