OP17
OCCUPATIONAL HEALTH MANAGEMENT OF MYASTHENIA GRAVIS AND THYMOMA: A LONGITUDINAL CASE STUDY IN THE AUTOMOTIVE MANUFACTURING SECTOR
- N. Naleem, Health Partners Group, East Sussex, UK
Background
Myasthenia gravis (MG) is a chronic autoimmune neuromuscular disorder characterised by fluctuating, fatiguable muscle weakness. Approximately 15–20% of individuals with MG develop a thymoma. This case study examines a long-serving car manufacturing electrician whose MG presented with severe bulbar, ocular, and respiratory symptoms, later complicated by a thymoma requiring thymectomy. His recovery was prolonged, with recurrent crises requiring tailored occupational health (OH) support.
Aims
To evaluate OH management strategies that support safe, sustainable employment for workers with MG and thymoma in physically demanding industrial environments.
Methods
A longitudinal review of his OH assessments from 2023–2025 was undertaken. Clinical progression, functional capacity, job demands, and workplace adjustments were analysed in relation to published MG management guidelines.
Results
The worker experienced extended work incapacity due to unpredictable flares, postoperative recovery, and intercurrent infection. Eventually a structured 10-week phased return, reduced manual load, infection risk mitigation, and schedule changes enabled gradual reintegration. These measures align with the Association of British Neurologists (ABN) 2025 MG guidelines, which emphasise individualised management and specialist oversight, with MG specific workplace recommendations advocating energy conservation, predictable schedules, and reasonable accommodations. Despite adjustments organisational constraints prevented continuation of the ideal arrangement, leading to voluntary redundancy after 40 years service.
Implications for policy or practice
This case highlights the need for flexible, bespoke adjustments, extended phased returns, and realistic expectations for fluctuating neurological conditions. Policies should support permanent schedule modifications, infection risk reduction, and multidisciplinary coordination to optimise outcomes for workers with complex neuromuscular disease, especially in heavy industry.
References:
- Association of British Neurologists (ABN). Autoimmune Myasthenia Gravis Management Guidelines (2025 Update). ABN; 2025.
- Jacob S, Farrugia ME, Hewamadduma C, et al. Association of British Neurologists autoimmune myasthenia gravis management guidelines (2025 update). Practical Neurology. 2025;25:422–437.
- Myaware. ABN Management Guidelines 2025 – Summary and Patient Facing Interpretation. Myaware; 2025.
- Myasthenia Gravis News. Occupational Therapy for Myasthenia Gravis. 2024.
- Myasthenia Gravis Foundation of America (MGFA). MG in the Workplace
