Ptosis, upward gaze (physician examination) | >45 seconds = 0 | 11-45 seconds = 1 | 1-10 seconds = 2 | Immediate = 3 |
Double vision on lateral gaze, left or right (physician examination) | >45 seconds = 0 | 11-45 seconds = 1 | 1-10 seconds = 3 | Immediate = 4 |
Eye closure (physician examination) | Normal = 0 | Mild weakness (can be forced open with effort) = 0 | Moderate weakness (can be forced open easily) = 1 | Severe weakness (unable to keep eyes closed) = 2 |
Talking (patient history) | Normal = 0 | Intermittent slurring or nasal speech = 2 | Constant slurring or nasal but can be understood = 4 | Difficult to understand speech = 6 |
Chewing (patient history) | Normal = 0 | Fatigue with solid food = 2 | Fatigue with soft food = 4 | Gastric tube = 6 |
Swallowing (patient history) | Normal = 0 | Rare episode of choking or trouble swallowing = 2 | Frequent trouble swallowing, for example necessitating change in diet = 5 | Gastric tube = 6 |
Breathing (thought to be caused by MG) | Normal = 0 | Shortness of breath with exertion = 2 | Shortness of breath at rest = 4 | Ventilator dependence = 9 |
Neck flexion or extension (weakest) (physician examination) | Normal = 0 | Mild weakness = 1 | Moderate weakness (ie, ~50% weak, ±15%) = 3 | Severe weakness = 4 |
Shoulder abduction (physician examination) | Normal = 0 | Mild weakness = 2 | Moderate weakness (ie, ~50% weak, ±15%) = 4 | Severe weakness = 5 |
Hip flexion (physician examination) | Normal = 0 | Mild weakness = 2 | Moderate weakness (ie, ~50% weak, ±15%) = 4 | Severe weakness = 5 |
TOTAL | _________ |