MG Assessment Tool:

Myasthenia Gravis Activities of Daily Living (MG-ADL)1

Care to know where you stand today? Complete and share with your doctor.

  • Complete the following questions to assess your generalized Myasthenia Gravis (gMG) symptoms and their impact on your daily activities.
  • Click on “Save as a PDF” button below to show the completed form to your doctor.
  • Click on “Add to MG-ADL Score Dashboard” button below to track your results on this device in your personal dashboard.
  • You can download your MG-ADL Score Dashboard to share your results with your doctor so you can both track your progress.
None = 0 Mild = 1 Moderate = 2 Severe = 3 Score

Talking

Normal

Intermittent slurring or nasal speech

Constant slurring or nasal speech, but can be understood

Difficult-to-understand speech

0

Chewing

Normal

Fatigue with solid food

Fatigue with soft food

Gastric tube

0

Swallowing

Normal

Rare episode of choking

Frequent choking necessitating changes in diet

Gastric tube

0

Breathing

Normal

Shortness of breath with exertion

Shortness of breath at rest

Ventilator dependence

0

Impairment of ability to brush teeth or comb hair

None

Extra effort, but no rest periods needed

Rest periods needed

Cannot do one of these functions

0

Impairment of ability to arise from a chair

None

Mild, sometimes uses arms

Moderate, always uses arms

Severe, requires assistance

0

Double vision

None

Occurs, but not daily

Daily, but not constant

Constant

0

Eyelid droop

None

Occurs, but not daily

Daily, but not constant

Constant

0

Patient name:

Total score

(sum of values)

0

(out of 24)

Patient name: xxxxx

Total Score 0

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MG-ADL assessment adapted from Wolfe GI, et al. 1999.1

Your MG-ADL scores and data related to your completion of the MG-ADL Assessment Tool and your personal MG-ADL Score Dashboard is stored locally on your own device and is not recorded, stored, processed, or shared by Alexion or any of its’ partners.

The information on this page is intended as educational information for healthcare providers. It does not replace a healthcare provider’s judgment or clinical diagnosis.

references:

  1. Wolfe GI, et al. Neurology. 1999;52(7):1487-1489.