Weakness and 'tiredness': when to suspect myasthenia gravis.

Initial complaints of bulbar paresis may be problems with chewing and swallowing. Patients often choose to eat soft puddings and cereals rather than meats or hard fruits because of the fatigue associated with chewing. Immunosuppressive therapy with prednisone can result in a long-lasting remission, and is recommended especially for those patients who are older or are medically unable to tolerate surgical treatment.