Diagnostic criteria

a. Characteristic signs and symptoms include one or more of the following:

i. Diplopia, ptosis, dysarthria, weakness in chewing, difficulty in swallowing, muscle weakness with preserved deep tendon reflexes, and, less commonly, weakness of neck extension and flexion, and weakness of trunk muscles.

ii. Increased weakness during exercise and repetitive use with at least partially restored strength after periods of rest.

iii. Dramatic improvement in strength following administration of anticholinesterase drug (edrophonium and neostigmine).

And one or more of the following:

b. EMG and repetitive stimulation of a peripheral nerve: In myasthenia gravis, repetitive stimulation at a rate of two per second shows characteristic decremental response that is reversed by edrophonium or neostigmine. Single-fiber studies show increased jitter.

c. Antibodies to acetylcholine receptors.

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