Myasthenia gravis (MG) can be difficult to diagnose in adults — and is even more challenging to diagnose in children, as autoantibodies are harder to detect in the pediatric population and symptoms can mimic other conditions. Only 10% of MG cases are found in children. Though juvenile myasthenia gravis is the most common, there are three different types of MG possible in children.
Transient neonatal myasthenia gravis
Transient neonatal MG is a mild and temporary type of MG that occurs in around 10% of newborns whose mothers have MG. It is caused by maternal antibodies crossing the placenta during pregnancy. Transient neonatal MG usually develops between birth and the third day of life, and generally resolves between two and four weeks later, with few long-term consequences. More than 90% of newborns with transient neonatal MG completely recover before the age of two months. However, more severe cases do exist.
Symptoms are often mild and can include floppiness, poor feeding, weak cry and difficulty breathing. If required, treatment may include medication plus breathing and feeding support.
Learn more about MG signs and symptoms
Juvenile myasthenia gravis
Juvenile MG is more similar to MG in adults, and is the most common form of pediatric myasthenia gravis. It most often develops around age 10 to 15, and is more commonly found in girls than boys. Like MG in adults, the ocular area is often affected. Other symptoms may include clumsiness, falling and shortness of breath. Symptoms may develop slowly, and are sometimes written off as laziness or a lack of motivation before they are recognized as medical problems.
Once diagnosis is confirmed, medication is prescribed to improve the nerve-muscle communication and to suppress the immune system, to inhibit the production of autoantibodies. Surgery to remove the thymus (called a thymectomy) may also be considered; though the thymus is important at younger ages for training the immune system, if a child is old enough then removing the thymus may help prevent MG from progressing.
While juvenile MG is a life-long disease, symptoms can be well-managed with effective treatment
Congenital myasthenia gravis
Congenital myasthenic syndrome is slightly different, as it not an autoimmune disease: it is an inherited genetic disorder. It occurs between birth and early childhood. Early symptoms may include weak cry, floppiness, muscle weakness that weakens with physical activity, breathing and feeding difficulties and delayed development milestones. In early childhood, droopy eyelids, poor eye control, double vision, slurred speech, difficulty chewing and swallowing and generalized muscle weakness.
If diagnosis is confirmed with genetic testing, medical treatment can begin to improve muscle strength and flexibility.
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