Presenting symptoms of myasthenia gravis and the major considerations in the differential diagnosis

Presenting symptoms	Other disorders to consider
Ocular (50%)	Brainstem and cranial nerve lesions (including Horner syndrome), thyroid ophthalmopathy, oculopharyngeal muscular dystrophy, chronic external ophthalmoplegia (mitochondrial disease)
Bulbar (15%)	Brainstem and multiple cranial nerve lesions, motor neuron disease, obstructive or malignant lesion of the nasal and oropharynx
Limb weakness (<5%)	Motor neuron disease, chronic inflammatory demyelinating polyneuropathy (CIDP) and other motor neuropathies, multiple radiculopathies, Lambert-Eaton myasthenic syndrome, myopathies
Isolated neck (uncommon)	Motor neuron disease, inflammatory myopathy, paraspinous myopathy
Isolated respiratory (rare)	Motor neuron disease, acid maltase deficiency, polymyositis
Distal limb (rare)	Motor neuron disease, CIDP and other motor neuropathies, distal myopathies

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