Myasthenia gravis most commonly affects adults and elderly, but it has been known to occur at any age.Presentation and causes of myasthenia like picture in children differ from adults.

Three types of myasthenic symptoms in children can be distinguished.

Neonatal Myasthenia Gravis

It occurs in 12% of the pregnancies with a mother with myasthenia gravis. In such cases the mother passes the antibodies to the infant through the placenta causing neonatal myasthenia gravis.

The symptoms will start in the first two days and disappear within a few weeks after birth.

Congenital Myasthenic Syndrome

Children of a healthy mother can, very rarely, develop myasthenic symptoms beginning at birth. This is called congenital myasthenic syndrome.  It is not caused by an autoimmune process, but due to synaptic malformation, which in turn is caused by genetic mutations.

Thus, CMS is a hereditary disease. More than 11 different mutations have been identified and the inheritance pattern is typically autosomal recessive.

The types of CMS are classified into three categories: presynaptic, postsynaptic, and synaptic.

Presynaptic symptoms include brief stops in breathing, weakness of the eye, mouth, and throat muscles. These symptoms often result in double vision and difficulty chewing and swallowing.

Postsynaptic symptoms in infants include severe muscle weakness, feeding and respiratory problems, and delays in the ability to sit, crawl, and walk. Onset symptoms for all ages may include droopy eyelids.

A particular form of postsynaptic CMS (slow-channel CMS) includes severe weakness beginning in infancy or childhood that progresses and leads to loss of mobility and respiratory problems in adolescence or later life.

Synaptic symptoms include early childhood feeding and respiratory problems, reduced mobility, curvature of the spine, and weakness, which causes a delay in motor milestones..

Juvenile Myasthenia Gravis

It is myasthenia occurring in childhood but after the peripartum period.

[Text adapted from Wikipedia]

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