Myasthenia gravis self-administered questionnaire: development of regional domains

The objective was to develop regional domains from the Myasthenia Gravis Questionnaire (MGQ) to better assess generalised, bulbar and ocular involvement in patients with myasthenia gravis (MG) and to evaluate their responsiveness. Some items from the MGQ were aggregated into 3 domains: bulbar, generalised and ocular. The study was carried out at the Institute of Neurology, EMG Service, Universita Cattolica, Rome, and the Department of Neurology, University Hospital, Modena, Italy. Ninety-three MG patients were prospectively enrolled in two neurological departments; furthermore, outcome after treatment was studied in 23 patients to evaluate responsiveness. Disease severity was scored according to a modified version of the Osserman classification and MGQ. The questionnaire appeared more sensitive than clinical examination and history to assess bulbar and ocular involvement. For example, according to the bulbar domain, 67 patients experienced bulbar symptoms whereas on clinical examination 51 of 67 were completely normal in the bulbar region. The MGQ domains appeared reliable and sensitive. Results of global MG score (GMG) and of domains appeared reliable. Domains were able to better assess the functional involvement of anatomical regions than main GMG, clinical examination and history.