Crisis 411: What You Need to Know About Myasthenic Crisis

Know the signs of an MG crisis? You should.

Life eventually teaches us the importance of preparing for emergencies before they happen. But life with MG makes this lesson even more important. A myasthenic crisis needs to be handled properly and quickly.^1-3 There are many reasons that you may delay creating an MG crisis plan. But wouldn’t you rather prepare for a crisis that never comes than deal with one without the right information? Here’s what you need to know.

What Is an MG Crisis?

A myasthenic crisis happens when worsening myasthenic weakness requires intubation or noninvasive ventilation to avoid intubation.¹ In other words, you can’t breathe without a ventilator and need immediate medical help.^1,3

Red Alert: Signs You’re in Crisis

There are many reasons for shortness of breath that have nothing to do with MG but may be equally troubling, including lung disease, heart problems, anxiety and more.⁴ However, any one of the following could signal you’re in MG crisis:

• In general, it feels harder to breathe.⁴
• You can’t complete sentences or count to 20 without getting out of breath.^3,4
• The muscles between your ribs and above the collarbone cave in when you breathe.³
• Your cough can’t clear saliva or phlegm.³

If you are struggling to breathe, it is very important to call 911 immediately.

What Is an Impending MG Crisis?

Before a full-blown crisis, you may experience an impending crisis. This is a flare or exacerbation that could lead to a crisis in days or weeks. The signs vary by case. Take any of them as an early warning—you’ll need closer monitoring at a hospital with aggressive treatment to prevent a full crisis.

Red Flags: Trouble with Chewing, Swallowing or Coughing

You might have a weak cough that is unable to clear your throat. You may cough frequently while eating and drinking. You could have trouble swallowing and need softer foods. Or you might get the sensation of liquids coming through your nose while swallowing.²

Other red flags are a drooping head, speech that's nasal or low volume, or needing to take a breath after every few words.³

If you experience any of these symptoms, you should go to a hospital immediately.

Yellow Flags: The Signs to Watch^2,5

Although breathing, chewing, swallowing and coughing are the most troublesome signs of an impending crisis, there are many others that might be easier to miss, at least at first. These include any worsening of your MG symptoms, from double vision, eye drooping, slurred speech and arm weakness, to falling and trouble walking.

Regular appointments with your doctor and symptom tracking may help you notice these signs early.