Often presents with alteration in gait or difficulty rising from a chair
Fluctuating symmetric weakness and fatigue, especially of proximal leg muscles
Improvement in strength with sustained or repeated exercise (in contrast to MG)<unk>  sign: handshake strength increases over several seconds
Myalgias
Muscle stiffness (especially in hip and shoulders)
Paresthesias
Metallic taste
Eye movements are unaffected
Sensory examination normal
Autonomic dysfunction (dry mouth, erectile dysfunction)
Compared with<unk>  gravis,<unk>  begins with lower extremities weakness and rarely begins with extraocular muscle weakness
Respiratory failure can occur in late stages of the disease
Paraneoplastic and autoimmune form of<unk>  have similar signs and symptoms<unk>  sign: handshake strength increases over several seconds
Lambert-Eaton myasthenic syndrome
Neuromuscular weakness
Guillain-Barre syndrome
Upper motor neuron:
Polymyositis
CVA
Amyotrophic lateral sclerosis
Hemorrhagic stroke