Myasthenia gravis (MG) can affect the head and neck muscles that you use to speak. If MG makes speaking more difficult, you may benefit from speech therapy.

MG is an autoimmune disease involving the neuromuscular function.

In MG, the immune system mistakenly targets healthy cells that allow nerves to send messages to muscles. As this connection is interrupted, muscles are less responsive to voluntary control and become weaker.

This muscle weakness can affect many aspects of daily living, such as speech and swallowing.

According to the Myasthenia Gravis Foundation of America (MGFA), 1 in 10 people with MG experience slurred speech and 2 in 100 people develop a voice disorder.

Learn more about the benefits of speech therapy for MG, when to consider it, and the duration of therapy.

When you speak, you use the muscles of your:

  • lungs
  • vocal cords
  • throat
  • lips
  • jaw
  • palate
  • tongue

If MG weakens any of these areas, it can affect the way your voice sounds.

According to the MGFA, some of the MG effects on speech may include:

  • slurred speech (dysarthria)
  • an overly nasal tone
  • poor breath support
  • vocal fatigue
  • pitch control issues
  • limited pitch changes (monotone)

You may not experience these effects when you first speak after a period of rest. However, as your voice gets tired, MG signs could become more apparent.

How does myasthenia gravis affect communication?

The effects MG has on the mechanics of speech can affect your ability to communicate.

Factors like volume, pace, and intonation are examples of how you use your voice to express the emotions behind your words. MG muscle fatigue can interfere with the way you convey your intentions and lead to misunderstandings.

MG may also change your ability to control your facial expressions. You might accidentally show “poker face” or an awkward, unusual, or poorly timed expression.

Communication challenges may impact your quality of life, possibly leading to:

  • social isolation
  • anxiety
  • stress
  • depression
  • reduced sleep

These are some of the factors that may also worsen MG symptoms.

A speech therapist, known as a speech-language pathologist (SLP), could help people with MG in several ways. These include:

Strengthening exercises are reserved for use in situations like:

  • while your medication is at its peak
  • during times of MG stability
  • during MG remission

MG muscle weakness isn’t the kind you strengthen with repetitions, like athletes in a gym.

Too much work may cause fatigue, which could increase your chance of a myasthenic crisis. This is a medical emergency that affects about 1 in 10 people with MG, during which your breathing muscles weaken so much that you require the support of a ventilator.

The MGFA recommends that you avoid strengthening exercises during exacerbations or myasthenic crises.

An SLP can also formally diagnose dysarthria or any other speech issues, such as a hoarse voice (dysphonia).

How do speech therapists treat dysphagia?

In addition to teaching you skills to speak with greater clarity and ease, an SLP can help if you have difficulty swallowing (dysphagia).

According to the American Speech-Language-Hearing Association, an SLP can help you learn to manage dysphagia by:

  • showing you swallowing exercises and maneuvers
  • helping you modify food consistency and the size of a single medication dosage
  • providing strategies like posture adjustments to help you swallow
  • providing electrical stimulation or biofeedback therapy
  • providing education about dysphagia

When are swallowing exercises contraindicated for myasthenia gravis?

Like speech exercises, swallowing exercises are not recommended during a myasthenic crisis, symptom exacerbation, or immediately before eating.

When your MG is stable or in remission, you can perform swallowing exercises during peak drug therapy.

You might benefit from speech therapy if your MG symptoms interfere with your:

  • speech sounds
  • communication
  • swallowing

The implications of these issues may be significant. Your ability to communicate has important social and occupational effects, and functional swallowing allows you to eat nutritious food and reduces your chances of choking.

That said, a 2023 review found that not enough people with MG are referred to SLPs for swallowing and speech difficulties. In fact, most referrals happen after people experience a myasthenic crisis.

A 2021 study in 111 participants with MG found that 74% had speech difficulties, but only 20% were referred to an SLP. The researchers also found that 85% of participants had swallowing difficulties, but only 26% were referred.

Consider speaking with a doctor about speech therapy if you experience:

  • a reluctance to answer questions or participate in conversations
  • unwanted social isolation
  • occupational limitations
  • unintended weight loss not from another illness

The duration of speech therapy for MG is based on your specific needs and symptom severity. An SLP can help you set up a treatment schedule.

If you’re experiencing a symptom flare, your speech therapist may recommend taking a break from your therapy, since MG symptoms usually improve with rest.

MG causes weakness in voluntary muscles in your body, including the ones in your head and neck.

If you’re interested in learning more about speech therapy for MG, consider speaking with your doctor. Keeping a log of your symptoms and any activities you do beforehand could help them assess the best treatment for you.

Speech therapy is an important treatment for many people living with MG. A speech therapist can help you improve your ability to communicate, as well as manage issues with swallowing.