Educational objective: Individuals with features of myasthenia gravis ( eg, fluctuating and fatigable ocularfbulbar weakness) should undergo confirmatory testing with acetylcholine receptor antibodies, which are highly specific. Those with an established diagnosis should subsequently undergo chest imaging (eg, CT scan, MRI) to evaluate for thymoma and for possible surgical planning, as thymectomy is associated with Jong-term clinical improvement in both patients with and without thymoma