Margarita Marchukneurologist · psychiatrist · psychotherapistSpecialist service
Diagnosis, treatment selection, and regular assessment for people with suspected or confirmed myasthenia gravis.
Fee for one online consultation.
MYASTHENIA — EXPLAINED CLEARLY
Myasthenia gravis is an autoimmune disorder that impairs signal transmission from nerves to muscles. Strength may decrease with activity and partially recover after rest. Symptoms vary: some people mainly experience drooping eyelids and double vision, while others develop limb weakness, voice changes, or difficulty chewing or swallowing.
If symptoms fluctuate during the day, antibody tests are negative, EMG findings conflict with the clinical picture, or treatment does not have the expected effect, the complete history should be reviewed rather than relying on a single investigation.
Review of medical records and previous prescriptions, assessment of symptoms and clinical scales, differential diagnosis, and a clear explanation of treatment options, risks, and criteria for changing the plan.
Infections, surgery and anaesthesia, vaccination, pregnancy planning, coexisting autoimmune or mental health conditions, and medicines that may worsen weakness each require a specific plan.
The patient receives a written plan explaining which tests are genuinely needed, how to take the prescribed treatment, what to monitor, when to return, and which warning signs require urgent care.
WHEN TO SEEK HELP
Suspected ocular or generalised myasthenia
Increasing weakness, double vision, swallowing or breathing difficulties
Insufficient benefit or adverse effects from treatment
Pregnancy planning and care in special situations
A second opinion or diagnostic review
Need for structured remote follow-up
The clinical conclusion after the appointment can be entered into Helsi and later used as part of the medical documentation, including for assessment of day-to-day functioning and disability status.
When clinically indicated, I issue referrals for necessary laboratory and instrumental investigations under Ukraine’s Programme of Medical Guarantees.
Regular laboratory monitoring is particularly important during treatment with cytostatic drugs or glucocorticoids: it helps identify adverse effects early and adjust treatment.
MedHelps is our purpose-built platform for people with myasthenia. Each patient has a personal account for storing test results, investigations, important events in the course of the condition, and treatment information.
It is a practical tool for every person with myasthenia: rather than relying only on subjective impressions, it helps identify deterioration early and intensify treatment, or confirm stable improvement and support a clinically justified dose reduction together with the doctor.
Access to the account is provided by the doctor after the consultation.
Symptoms, their daily variability, triggers, previous clinical conclusions, and the complete treatment history.
Antibody testing, electromyography, thymus imaging, laboratory investigations, and differential diagnosis.
Discussion of options, expected benefits, risks, adverse effects, and criteria for changing the plan.
MG-ADL, MG-QoL15R, QMG, documents, and tasks in the secure MedHelps account.
PROOF OF QUALIFICATIONS
SPECIALIST BACKGROUND
Specialist placement at City Clinical Hospital No. 51 under the supervision of Professor D. V. Sidnev.
Bogomolets National Medical University. Research topic: clinical and paraclinical characteristics of myasthenia gravis during acute intercurrent illness.
Work in Neurology Department No. 2 at Kyiv City Clinical Hospital No. 4 with patients who have myasthenia and other neuromuscular disorders.
Diagnosis, second opinions, treatment adjustment, and long-term follow-up for people with myasthenia gravis.
Complex myasthenia cases, exacerbations, comorbidities, and neuromuscular disorders.
Collaboration with the Institute of Hereditary Pathology of the National Academy of Medical Sciences of Ukraine and Invitae Laboratory in the United States when a hereditary disorder is suspected.
Experience supporting people with different forms of myasthenia gravis, treatment regimens, and complex comorbidities.
A dedicated platform for MG-ADL, MG-QoL15R, QMG, symptoms, documents, and treatment between consultations.
PATIENT SUPPORT INFRASTRUCTURE
The organisation was established to develop systematic support for people with myasthenia gravis through accessible information, patient connections, educational projects, and modern monitoring tools. The organisation is led by Margarita Marchuk.
Learn more about the organization ↗PUBLIC CREDENTIALS
A structured review of medicines that may impair neuromuscular transmission and the principles of safer prescribing.
Open the original source ↗Clinical pointers for recognising myasthenia gravis and distinguishing it from other causes of ptosis, diplopia, and muscle weakness.
Open the original source ↗How to distinguish psychiatric symptoms from manifestations of neuromuscular disease and recognise coexisting conditions.
Open the original source ↗A practical review of diagnosis, clinical presentation, and the principles of caring for people with myasthenia gravis.
Open the original source ↗A clinical case published in a Wiley journal, with the full text available in PubMed Central.
Open the original source ↗A specialist presentation on treatment selection, safety, and practical management of adverse effects.
An educational presentation on differential diagnosis and critical points in clinical decision-making.
Original research with DOI 10.30978/UNJ2022-3-25.
Open the original source ↗MYASTHENIA — PRACTICAL GUIDANCE
Yes. Physical activity is often recommended for people with myasthenia, but it is important to choose exercises that do not cause marked fatigue and to respect individual limitations. Discuss suitable levels of activity with your doctor. Personalised healthy-lifestyle guidance can be developed as part of treatment.
Yes. Although myasthenia is rare in children, it can occur. Muscle weakness that worsens with activity should be assessed promptly by a doctor for diagnosis and treatment.
Yes. Many people with myasthenia lead full and active lives with appropriate treatment and symptom monitoring. An individual plan takes account of your usual lifestyle, daily routine, travel, work, and study.
Regular follow-up is usually needed, especially when treatment begins. The frequency depends on symptom severity and the chosen therapy. The follow-up plan is designed to combine effective treatment with a manageable daily life.
Autoimmune myasthenia gravis is not usually inherited directly, and most people have no family history of the condition. Genetic susceptibility may contribute to risk, but it does not make the disease inevitable. Rare congenital myasthenic syndromes are separate disorders with a different cause.
Adverse effects depend on the medication and may include gastrointestinal symptoms, weight gain, acne, hair loss, increased blood glucose or blood pressure, changes in liver tests, and a higher risk of infection. I explain the relevant risks and tailor treatment to the individual.
Yes. Women with myasthenia can become pregnant and have a healthy baby, but pregnancy requires planning and close medical monitoring. Before conception, it is important to assess disease stability and adjust treatment if needed.
Autoimmune myasthenia gravis is not usually inherited directly by the child. However, maternal antibodies can cross the placenta and may rarely cause temporary neonatal myasthenia. More rarely, antibodies directed against the fetal type of acetylcholine receptor can reduce fetal movement and increase the risk of fetal akinesia and arthrogryposis. The risk depends on the specificity of the antibodies produced by the mother, so it should be discussed during a pre-pregnancy consultation, together with a plan for monitoring during pregnancy, delivery, and after birth.
It is important to avoid overexertion and overheating, plan sufficient rest, reduce the risk of infection, and follow the agreed treatment regimen. Specific advice on activity, nutrition, sleep, and daily life is tailored to your symptoms and needs.
First step