Why does myasthenia gravis (MG) affect the extraocular muscles first?

Updated: Aug 27, 2018
  • Author: Abbas Jowkar, MD; Chief Editor: Nicholas Lorenzo, MD, MHA, CPE  more...
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Answer

The question of why MG affects the extraocular muscles first and predominantly remains unanswered. The answer probably has to do with type and distribution of NMJs in at least some of the muscles affected by the disease.

The distinctive features in MG, particularly the fluctuating nature of a patient's strength, is attributed to the unique pathophysiology of impaired neuromuscular transmission. This pathophysiology produces a dynamic rather than a fixed disorder as a result of the relative ease by which NMJs repair.


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