Distal myasthenia gravis

Myasthenia gravis (MG) characteristically involves ocular, bulbar, and prox imal extremity muscles. Distal extremity muscles are typically spared or le ss prominently involved. The authors performed a retrospective chart review of MG patients treated at two university-based neuromuscular clinics. From a total population of 236, nine patients (3%) had distal extremity weaknes s exceeding proximal weakness by at least one Medical Research Council grad e during their illness. Hand muscles, particularly fin ger extensors, were involved more frequently than were distal leg and foot muscles.