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The most common symptoms of myasthenia gravis are double vision (diplopia), drooping eyelids (ptosis), and muscle weakness that usually gets worse after exercise or at the end of the day and improves with rest.

The muscles around the eyes are particularly likely to be affected by myasthenia gravis, and eye problems are the first sign of the disease in about 40% of cases. Eventually, almost everyone with myasthenia gravis will experience eye symptoms. About 15% of people experience symptoms only around the eyes and nowhere else ? this is called ocular myasthenia gravis.

Other common symptoms of this disease include:

- blurred vision

- difficulty chewing or swallowing

- inability to stand up without using hands

- unstable or unusual gait

- weakness in the arms, legs, hands, and fingers

- weakness in the muscles of facial expression

Many people find that their symptoms rise and fall in intensity many times in the course of a single day. Often, they follow a similar pattern each day, with muscle fatigue at its worst in the evening.

People who find it temporarily impossible to eat may have to be admitted to hospital and be fed intravenously. Of more immediate danger is when the disease causes difficulty in breathing. This is called a myasthenic crisis, and it's responsible for most of the small number of deaths due to myasthenia gravis. People with breathing problems must go to a hospital immediately.

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