Myasthenia Gravis Score Calculator

Barre Maneuver
Upper limbs extended horizontally in anteroposition (1 point per 10 seconds)
Mingazzini maneuver
Lower limbs, patient in the supine position, thighs flexed at 90° on the pelvis, legs at 90° on the thighs: (1 point per 5 seconds)
head bending
The patient is in the supine position
The transition from lying to sitting position
Extrinsic eye movement
Ocular and palpebral motor skills
Palpebral occlusion
Chewing
The patient is able to hold a tongue depressor between the teeth against resistance
Swallowing
Phonation



Score :

What is the Myasthenia Gravis Score Calculator?

The Myasthenia Gravis Score Calculator is a specialized medical assessment tool designed to measure the degree of muscle weakness in patients diagnosed with Myasthenia Gravis (MG). This calculator utilizes a standardized scoring system based on specific clinical maneuvers, including limb positioning, head movements, eye muscle function, chewing, swallowing, and speech. By objectively evaluating these functions, healthcare providers can accurately quantify muscle impairment and gauge the severity of the patient's condition.

The calculator features individual assessments such as the Barre maneuver for upper limbs, Mingazzini maneuver for lower limbs, and various other targeted tests. The combined results produce a total numerical score that provides valuable insights into the patient's muscle functionality and overall physical capabilities.

Why use this calculator?

  • Objective assessment: The calculator provides a structured, standardized approach to evaluating muscle weakness, eliminating subjective judgment and enhancing reliability.
  • Monitoring disease progression: Regular use allows healthcare providers to track disease progression or improvement over time, facilitating timely adjustments to treatment plans.
  • Treatment effectiveness: By quantifying changes in muscle strength, the calculator helps determine the effectiveness of medications, therapies, or surgical interventions for Myasthenia Gravis.
  • Improved patient care: With accurate measurements, healthcare professionals can provide personalized, evidence-based care tailored specifically to individual patient needs.
  • Enhanced communication: Clearly defined numerical scores make it easier to communicate patient status among medical teams, specialists, and caregivers.
  • Early intervention: Prompt identification of significant changes or deterioration in muscle function allows for timely medical intervention, reducing the risk of severe complications.
  • Patient involvement: Using a structured scoring system encourages patient participation and awareness of their condition, enabling better self-management and adherence to prescribed treatments.

How the Calculator Works

The Myasthenia Gravis Score Calculator evaluates muscle strength by assigning points based on the patient's ability to perform specific physical maneuvers and tasks. Each task is designed to measure strength in different muscle groups commonly affected by Myasthenia Gravis.

The evaluation process includes:

  • Barre Maneuver: Measures strength in the upper limbs by assessing how long the patient can hold their arms horizontally extended.
  • Mingazzini Maneuver: Evaluates lower limb strength by timing how long the patient maintains legs elevated while lying on their back.
  • Head Bending: Checks neck muscle strength by assessing resistance to bending.
  • Transition from Lying to Sitting: Assesses core muscle function by testing if the patient can sit up without assistance.
  • Extrinsic Eye Movement: Evaluates eye and eyelid muscle function, detecting conditions like ptosis (drooping eyelids) or double vision.
  • Palpebral Occlusion: Tests the strength of eyelid closure.
  • Chewing Ability: Measures jaw muscle strength using resistance tests, such as holding a tongue depressor between teeth.
  • Swallowing Function: Determines if swallowing is normal or if there is dysphagia, which may risk aspiration.
  • Phonation: Assesses voice strength and clarity, distinguishing between normal speech, nasal speech, or complete voice loss.

Points from each test are added together to produce a total score, reflecting the overall severity of muscle impairment. A higher total score indicates better muscle function, while a lower score suggests significant muscle weakness and impairment.

Regular use of this calculator allows medical professionals to monitor the progression of Myasthenia Gravis accurately and adjust treatment strategies accordingly.

Assessment Criteria

Barre Maneuver

Evaluates upper limb strength by having the patient extend both arms horizontally in front. Points are awarded based on how long the patient can maintain this position without support, with longer durations indicating better muscle strength.

Mingazzini Maneuver

Assesses lower limb strength. The patient lies flat on their back with legs and thighs flexed at 90 degrees. Strength is measured by timing how long the patient maintains this position without assistance, reflecting the endurance of leg muscles.

Head Bending

Evaluates the strength of neck muscles by assessing the patient's ability to lift or flex the head against resistance. Scoring indicates the ability to resist external force, highlighting potential neck muscle weakness.

Transition from Lying to Sitting Position

Measures core muscle strength and control. The patient is asked to move from lying flat to sitting upright without using their hands or assistance. The ability to complete this maneuver independently indicates robust core strength.

Extrinsic Eye Movement

Checks the functionality of the muscles controlling eye movements. Evaluation includes testing for normal eye motion, identifying isolated drooping eyelids (ptosis), or recognizing double vision (diplopia) to assess ocular muscle involvement.

Palpebral Occlusion

Assesses eyelid muscle strength by checking if the patient can fully close their eyelids. Complete closure indicates normal function, while incomplete or absent closure highlights potential muscle impairment.

Chewing

Evaluates jaw muscle strength by determining if the patient can firmly hold a tongue depressor or similar object between their teeth against resistance. This helps identify reduced muscle function that can interfere with eating.

Swallowing

Checks the patient's swallowing capability, identifying normal function or the presence of swallowing difficulties (dysphagia). Scoring reflects whether swallowing is normal, mildly impaired, or significantly compromised, potentially risking aspiration.

Phonation

Assesses voice clarity, strength, and speech quality. Evaluation distinguishes between normal vocalization, nasal speech, or complete loss of voice (aphonia), reflecting involvement of muscles used for speech.

How to Interpret Your Score

The Myasthenia Gravis Score Calculator provides a numerical value that reflects the severity of muscle weakness. The total score is calculated by summing up the points assigned to each maneuver, with higher scores indicating better muscle function and lower scores suggesting more severe weakness.

Score Ranges and Their Meaning

  • 80 - 100: Normal or minimal muscle weakness. The patient retains good muscle function with little to no noticeable impairment.
  • 50 - 79: Mild muscle weakness. The patient may experience occasional fatigue or mild difficulty with certain movements but remains mostly functional.
  • 30 - 49: Moderate muscle weakness. Muscle function is noticeably impaired, affecting daily activities such as walking, lifting objects, or prolonged standing.
  • 10 - 29: Severe muscle weakness. The patient experiences significant difficulty in movement, with tasks like standing, swallowing, and speaking becoming challenging.
  • 0 - 9: Extreme muscle weakness. The patient may have difficulty performing essential tasks, requiring medical assistance for mobility, swallowing, or breathing support.

What to Do Based on Your Score

  • High Score (80+): If your score is within this range, your muscle strength is strong. Regular monitoring is still recommended to detect early signs of progression.
  • Moderate Score (30 - 79): You may need lifestyle adjustments, medications, or physical therapy to maintain muscle function and prevent further decline.
  • Low Score (0 - 29): A low score indicates significant impairment. Immediate medical attention is advised to prevent complications and optimize treatment.

If you notice a rapid decline in your score over time, consult a healthcare professional for further evaluation and possible treatment adjustments.

Frequently Asked Questions (FAQs)

1. What is the Myasthenia Gravis Score Calculator used for?

The Myasthenia Gravis Score Calculator is used to assess muscle weakness in patients with Myasthenia Gravis (MG). It helps track disease progression and evaluate treatment effectiveness by assigning a numerical score based on muscle performance in various tasks.

2. Who can use this calculator?

This tool is primarily designed for healthcare professionals, including doctors and physical therapists, to monitor Myasthenia Gravis patients. However, patients can also use it under medical guidance to track changes in their condition.

3. How is the score calculated?

The score is determined by evaluating a series of physical maneuvers, such as limb positioning, head movements, eye muscle function, chewing, swallowing, and speech. Each maneuver is assigned points based on the patient's ability to perform it, and the total score reflects overall muscle strength.

4. What does my score mean?

- 80 - 100: Normal or minimal weakness.
- 50 - 79: Mild weakness.
- 30 - 49: Moderate weakness.
- 10 - 29: Severe weakness.
- 0 - 9: Extreme weakness, requiring urgent medical attention.

5. How often should I use the calculator?

The frequency depends on your condition and medical recommendations. Patients undergoing treatment may use it weekly or monthly to track progress, while others may use it less frequently for periodic assessment.

6. Can this calculator diagnose Myasthenia Gravis?

No, this calculator is not a diagnostic tool. It is designed for monitoring muscle weakness in patients already diagnosed with Myasthenia Gravis. If you suspect you have MG, consult a healthcare provider for proper diagnosis.

7. What should I do if my score decreases over time?

If you notice a decline in your score, contact your doctor immediately. A lower score may indicate disease progression or an ineffective treatment plan that requires adjustments.

8. Can the calculator be used for other neuromuscular diseases?

While this calculator is specifically designed for Myasthenia Gravis, some of its assessment criteria may apply to other neuromuscular disorders. However, it should not be used as a substitute for condition-specific evaluations.

9. Is this calculator a substitute for a professional medical evaluation?

No. While the calculator provides useful insights, it should not replace professional medical assessments. Always consult a healthcare provider for an accurate diagnosis and treatment plan.

10. Can I improve my score?

Yes. With proper treatment, physical therapy, and lifestyle modifications, many patients can improve their muscle strength and functionality, leading to a higher score over time.

References

  • Myasthenia Gravis and Related Disorders – Engel, A. G. & Santoro, L. – 2003 – Oxford University Press
  • Myasthenia Gravis: A Manual for the Health Care Provider – Gilhus, N. E., Verschuuren, J. J., & Evoli, A. – 2018 – Springer
  • Myasthenia Gravis: A Clinical Guide – Howard, J. F. – 2016 – Humana Press
  • Neurology Secrets – Pascuzzi, R. M. – 2010 – Elsevier
  • Adams and Victor's Principles of Neurology – Ropper, A. H., Samuels, M. A., & Klein, J. P. – 2019 – McGraw Hill
  • Handbook of Clinical Neurology: Myasthenia Gravis and Related Disorders – Vinken, P. J., Bruyn, G. W., & Klawans, H. L. – 1994 – Elsevier
  • Myasthenia Gravis and Related Disorders: Mechanisms and Management – Vincent, A. – 2018 – Academic Press

Disclaimer

The Myasthenia Gravis Score Calculator is a clinical support tool designed for healthcare professionals. It is intended to aid in assessing muscle strength in individuals diagnosed with Myasthenia Gravis and should be used in conjunction with a full medical evaluation.

This calculator does not provide a medical diagnosis and should not be used by patients for self-diagnosis or as a substitute for professional medical advice. Results should always be interpreted by a qualified clinician, taking into account the patient’s complete medical history, physical examination, and relevant laboratory or diagnostic studies.

Although the scoring system offers a standardized method for monitoring disease progression, it may not capture all nuances of the condition, especially in atypical presentations or when other neuromuscular disorders are present. Scores may also be influenced by patient effort, comorbidities, or other external factors.

Use of this tool is at the user’s own risk. The creators and distributors of the calculator assume no responsibility for clinical decisions or outcomes resulting from its use. For any medical concerns, changes in symptoms, or treatment decisions, always consult a licensed healthcare provider.

In case of acute symptoms such as respiratory difficulty, swallowing impairment, or severe weakness, seek immediate medical attention.