3 symptoms of myasthenia gravis that are often misunderstood

Myasthenia gravis (MG) comes with symptoms that rarely behave the way people might expect. They tend to be subtle, they’re often invisible, and they get misread constantly — sometimes in ways that are annoying, sometimes in ways that are unintentionally hilarious.

In my experience, the following three MG symptoms are the ones people most often misunderstand.

Slurred speech: No, I’m not drunk or high

Bulbar weakness is one of MG’s most misunderstood symptoms because people jump to the wrong conclusion — quickly. When my speech starts to drag or blur, folks don’t think “neuromuscular disease.” They think I’ve been drinking.

Spoiler alert: I don’t drink.

I’ve had slurred speech be mistaken for my being drunk, high, overly medicated, or “out of it.” None of those were true. My muscles were simply too tired to shape words cleanly.

It can happen mid‑conversation, mid‑sentence, or mid‑syllable. Sometimes there is little to no warning. One minute I’ll be talking, and the next, I sound like a 60-year-old, two-pack-a-day smoker on a bender.

I’m not impaired or drunk. My muscles are tired. That’s it.

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No smile: Welcome to my ‘resting b—- face’

Facial weakness is another symptom people misread constantly. When MG hits those tiny muscles that lift your cheeks and shape your expression, your smile becomes optional — physically optional.

People have assumed I’m irritated, bored, or silently judging them. I’ve been told I look “intense,” “serious,” or “like I’m about to fight someone.” Honestly? It’s kind of funny. But really, it’s just that the muscles in my face have decided they’re done and have checked out.

MG turns my expression into “resting b—- face” — a look that says “I have opinions” even when I’m thinking about snacks or trying to remember where I left my water bottle.

Yawning and air hunger: Not boredom or rudeness

I’ve found that this one surprises folks the most: Yawning can be an MG symptom. When my respiratory muscles weaken, I can’t pull in a full breath. My body tries to compensate by triggering yawns — big, dramatic ones — to force more air in.

It looks like I’m bored, tired, or being rude. It looks like I’m disengaged or ready to go home. But yawning is actually one of my outward signs of air hunger, my body struggling to get enough oxygen because the muscles responsible for breathing are fatigued.

It’s not boredom (usually). It’s not disrespect or “I stayed up too late.” It’s my diaphragm waving a tiny white flag.

Misreading MG symptoms isn’t just awkward; it can be unsafe. When people, especially medical professionals, assume that slurred speech means intoxication, that a blank expression means irritation, or that yawning means boredom, they respond to the wrong problem. I’ve had this happen more times than I can count.

Understanding the real cause helps people better support us, trust our lived experience, and recognize that MG is rarely loud or dramatic. More often than not, it’s quiet, subtle, and hiding in plain sight.

Note: Myasthenia Gravis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Myasthenia Gravis News or its parent company, Bionews, and are intended to spark discussion about issues pertaining to myasthenia gravis.