In approx. 65% of cases the extrinsic ocular muscles present the primary symptoms

Early symptoms

  • Weakness of eye muscles
  • Trouble swallowing
  • Slurred speech


Later symptoms

  • Moderate to severe drooping of one or both eyelids
  • Double vision
  • Blurred vision
  • Trouble walking
  • General weakness especially in the voluntary muscles
  • Facial expression
  • Shortness of breath
  • Fatigue in the neck and jaws
  • Trouble holding the head up
  • Difficulty swallowing



Picture available from Rare association of thymoma, myasthenia gravis and sarcoidosis : a case report via creative commons license