MDCalc

Myasthenia Gravis Activities of Daily Living (MG-ADL)

Assesses disease severity in patients with myasthenia gravis (MG).

Keep the recall window consistent (e.g., “during the past 7 days”) at every administration to ensure comparability.

Talking

Chewing

Swallowing

Breathing

Impairment of ability to brush teeth or comb hair

Impairment of ability to arise from a chair

Double vision

Eyelid droop

Result:

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Advice
  • Interpret alongside neurologic examination, pulmonary function (FVC/NIF), and patient goals.
  • Higher scores indicate greater disability.
  • Aim for a score ≤1 (“minimal symptom expression”) when pursuing remission.
  • A ≥2-point change is considered the minimal clinically important difference (MCID).
Management
  • If target score is reached:
    • Reinforce medication adherence.
    • Consider deescalating care.
    • Extend visit intervals while continuing remote patient-reported outcome monitoring.
  • If the score remains elevated or continues to rise despite treatment:
    • Confirm treatment adherence.
    • Check for thyroid or infectious triggers.
    • Escalate therapy, as needed.
Critical Actions

Measure FVC and negative inspiratory force (NIF), and refer the patient to the emergency department if a myasthenic crisis is suspected.

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