That rare disease known as myasthenia gravis is one in which there is a curious train of symptoms, the chief characteristic being a peculiar exhaustion which is confined to the voluntary muscular system, and which is aggravated by repetition of functional acts, the asthenic muscles being those that have generally been used the most.
This species of weakness does not necessarily end fatally, unless it be due to some serious lesion, but the prognosis on the whole is bad. There are some patients who have been apparently rapidly cured, although this sometimes seems incredible when we take into account the general and appalling disturbance of function; and it is probable that when lost sight of they have relapsed.
There are several forms of myasthenia gravis, the most common and important of which is the bulbar variety.
As Mills1 has pointed out, certain cases have been described as "asthenic bulbar
HAMILTON AM. A CASE OF ASTHENOBULBOSPINAL PARALYSIS (MYASTHENIA GRAVIS). JAMA. 1912;LVIII(21):1561-1563. doi:10.1001/jama.1912.04260050237002