Telemedicine visits in myasthenia gravis: Expert guidance and the Myasthenia Gravis Core Exam (MG-CE)

Introduction/Aims Telemedicine may be particularly well-suited for myasthenia gravis (MG) due to the disorder's need for specialized care, its hallmark fluctuating muscle weakness, and the potential for increased risk of virus exposure among patients with MG during the coronavirus disease 2019 (COVID-19) pandemic during in-person clinical visits. A disease-specific telemedicine physical examination to reflect myasthenic weakness does not currently exist. Methods This paper outlines step-by-step guidance on the fundamentals of a telemedicine assessment for MG. The Myasthenia Gravis Core Exam (MG-CE) is introduced as a MG-specific, telemedicine, physical examination, which contains eight components (ptosis, diplopia, facial strength, bulbar strength, dysarthria, single breath count, arm strength, and sit to stand) and takes approximately 10 minutes to complete. Results Pre-visit preparation, remote ascertainment of patient-reported outcome scales and visit documentation are also addressed. Discussion Additional knowledge gaps in telemedicine specific to MG care are identified for future investigation.

Automated summary

Telemedicine may be well-suited for myasthenia gravis (MG) due to its specialized care needs, fluctuating muscle weakness, and potential for increased virus exposure during the COVID-19 pandemic. This paper outlines step-by-step guidance on a telemedicine assessment for MG, introducing the MG-CE as a MG-specific, telemedicine physical examination with eight components. Pre-visit preparation, remote patient-reported outcome scales, and visit documentation are also addressed, with identified knowledge gaps for future investigation in telemedicine specific to MG care.