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MG Assessment Tool:

Quantitative Myasthenia Gravis (QMG) Score¹

The QMG test is easy to administer, taking approximately 30 minutes and requiring minimal equipment.¹
The QMG test has been shown to correlate well with the myasthenia gravis activities of daily living (MG-ADL) scoring system.²

General instructions:¹

Patients must stop pyridostigmine treatment (or any acetylcholinesterase inhibitor medication) for 12 hours prior to testing, if medically safe to do so.
Calibrate the respiratory equipment per manufacturers’ instruction prior to testing. Maintain the calibration record in an accessible place.
For all measurements, record the actual number as well as the grade. For example, if it takes 30 seconds before a patient sees double, record in the far-right box 30/1 for 30 seconds and a grade of 1.
Patients must remain seated for the respiratory test.
At the end of the scoring sheet, add up the grade for that patient—this is the Total QMG Score.

Required equipment:¹

Spirometer that can be calibrated.
Mouthpieces that fit the spirometer, nose clips.
Stopwatch.
Cups and water for swallowing tests.
Goniometer.
Dynamometer.
Disposable gloves (if desired).

	None=0	Mild=1	Moderate=2	Severe=3
Double vision on lateral gaze right or left (circle one), seconds	61	11–60	1–10	Spontaneous
Ptosis (upward gaze), seconds	61	11–60	1–10	Spontaneous
Facial muscles	Normal lid closure	Complete, weak, some resistance	Complete, without resistance	Incomplete
Swallowing 4 oz of water (1/2 cup)	Normal	` Minimal coughing or throat clearing	Severe coughing/choking or nasal regurgitation	Cannot swallow (test not attempted)
Speech after counting aloud from 1 to 50 (onset of dysarthria)	None at 50	Dysarthria at 30–49	Dysarthria at 10–29	Dysarthria at 9
Right arm outstretched (90-degree sitting), seconds	240	90–239	10–89	0–9
Left arm outstretched (90-degree sitting), seconds	240	90–239	10–89	0–9
Vital capacity, % predicted	≥ 80	65–79	50–64	< 50
Right-hand grip (men), kgW	≥ 45	15–44	5–14	0–4
Right-hand grip (women), kgW	≥ 30	10–29	5–9	0–4
Left-hand grip (men), kgW	≥ 35	15–34	5–14	0–4
Left-hand grip (women), kgW	≥ 25	10–24	5–9	0–4
Head lifted (45-degree supine), seconds	120	30–119	1–29	0
Right leg outstretched (45-degree supine), seconds	100	31–99	1–30	0
Left leg outstretched (45-degree supine), seconds	100	31–99	1–30	0

None=0

Mild=1

Moderate=2

Severe=3

Score

Double vision on lateral gaze right or left (circle one), seconds

11–60

1–10

Spontaneous

Ptosis (upward gaze), seconds

11–60

1–10

Spontaneous

Facial muscles

Normal lid closure

Complete, weak, some resistance

Complete, without resistance

Incomplete

Swallowing 4 oz of water (1/2 cup)

Normal

Minimal coughing or throat clearing

Severe coughing/choking or nasal regurgitation

Cannot swallow (test not attempted)

Speech after counting aloud from 1 to 50 (onset of dysarthria)

None at 50

Dysarthria at 30–49

Dysarthria at 10–29

Dysarthria at 9

Right arm outstretched (90-degree sitting), seconds

240

90–239

10–89

0–9

Left arm outstretched (90-degree sitting), seconds

240

90–239

10–89

0–9

Vital capacity, % predicted

≥ 80

65–79

50–64

< 50

Right-hand grip (men), kgW

≥ 45

15–44

5–14

0–4

Right-hand grip (women), kgW

≥ 30

10–29

5–9

0–4

Left-hand grip (men), kgW

≥ 35

15–34

5–14

0–4

Left-hand grip (women), kgW

≥ 25

10–24

5–9

0–4

Head lifted (45-degree supine), seconds

120

30–119

1–29

Right leg outstretched (45-degree supine), seconds

100

31–99

1–30

Left leg outstretched (45-degree supine), seconds

100

31–99

1–30

Patient name:

Date:

Total score

(sum of values)

0

Patient name: xxxxx

Date: xxxxx

Total Score 0

QMG assessment adapted from Barohn RJ, et al. 1999.¹
The information on this page is intended as educational information for healthcare providers. It does not replace a healthcare provider’s judgement or clinical diagnosis.

references:

Barohn RJ, et al. Ann N Y Acad Sci. 1998;841:769-772.
Wolfe GI, et al. Neurology. 1999;52(7):1487-1489.

MG Assessment Tool:

Quantitative Myasthenia Gravis (QMG) Score1

General instructions:1

Required equipment:1

0

Quantitative Myasthenia Gravis (QMG) Score¹

General instructions:¹

Required equipment:¹