Myasthenia Gravis Clinics in the UK: Specialist Centres and How to Get Referred

Finding specialist care for myasthenia gravis (MG) can feel complicated. MG is a rare autoimmune neuromuscular condition, and not every neurology service has the same level of experience with it.

The UK has several specialist neuromuscular centres and dedicated myasthenia gravis services. However, the way you reach them depends on where you live, your current NHS care and the referral criteria of the individual centre.

This guide explains where specialist MG services can be found in the UK, how NHS referrals usually work, when a specialist opinion may be considered and what information can be useful to prepare before an appointment.

TL;DR

• Myasthenia gravis is usually managed within neurology, with some NHS hospitals offering dedicated MG or specialist neuromuscular clinics.
• Specialist centres include services at Queen Square, St George’s, King’s College Hospital, Imperial College Healthcare, The Walton Centre, Leeds Teaching Hospitals and University Hospitals Birmingham.
• Referral routes differ. Some centres accept GP referrals, while others normally require general neurology assessment first.
• Writing down fluctuating symptoms, medicines, previous test results and questions can help you prepare for an appointment.
• Experience data from mama health highlights recurring challenges around explaining changing symptoms, remembering patterns and making the most of short medical appointments.
• Severe or worsening breathing or swallowing difficulty can be an emergency. Call 999 if this happens.

What is a specialist myasthenia gravis clinic?

A specialist myasthenia gravis clinic is a neurology service with particular expertise in MG and other disorders of the neuromuscular junction.

Myasthenia gravis affects communication between nerves and muscles. Weakness can involve the eyelids, eye muscles, face, jaw, throat, neck, arms, legs and breathing muscles.

Symptoms can also fluctuate. They may become more noticeable after repeated muscle use or later in the day.

You can read more about myasthenia gravis symptoms, ptosis and myasthenic crisis.

Specialist MG services may involve neurologists, neurophysiologists, specialist nurses, respiratory specialists, speech and language therapists, physiotherapists and other healthcare professionals. The exact team varies between hospitals.

Access to specialist neurophysiology and antibody testing can also be important when MG is being investigated. Our guide to myasthenia gravis diagnosis and tests explains these investigations in more detail.

Which specialist myasthenia gravis clinics are available in the UK?

Several UK centres publicly document dedicated MG clinics or neuromuscular services with specific MG expertise. The centres below are examples rather than a complete directory.

Referral requirements can change, so the current pathway should always be checked with the service or referring healthcare professional.

National Hospital for Neurology and Neurosurgery, Queen Square, London

The Centre for Neuromuscular Diseases at the National Hospital for Neurology and Neurosurgery, Queen Square is a major UK specialist neuromuscular centre.

Its neuromuscular service covers myasthenia gravis and other neuromuscular-junction disorders alongside muscle diseases, peripheral neuropathies and other rare neuromuscular conditions.

The centre brings together neurologists, neurophysiologists, specialist nurses and several other disciplines. It also has specialist myasthenia clinics.

The service lists the NHS e-Referral Service among its referral routes.

St George’s Hospital Myasthenia Clinic, London

St George’s Hospital has a dedicated myasthenia clinic within the Atkinson Morley Neuromuscular Centre.

The clinic runs weekly and works closely with neurophysiology. St George’s also has access to neurological day-care and neurological intensive-care services.

Its wider neuromuscular centre states that someone with a neuromuscular condition can ask their GP about referral to the service.

King’s College Hospital Muscle and Myasthenia Service, London

King’s College Hospital has a dedicated Muscle and Myasthenia Service within its neurology department.

The service covers myasthenia gravis, Lambert-Eaton myasthenic syndrome, congenital myasthenic syndromes and several muscle disorders.

It includes specialist neurological and nursing expertise in myasthenia gravis.

King’s publishes a routine written referral pathway for the service. If you have previously been seen elsewhere, the hospital also recommends bringing copies of relevant letters and investigation results to your appointment.

Imperial College Healthcare Muscle and MG Service, London

Imperial College Healthcare provides specialist expertise in muscle disorders and myasthenia gravis at Charing Cross Hospital.

Its Muscle and MG Service receives requests for specialist opinions from across north-west London and further afield.

Access to the service will depend on the reason for referral and the pathway used by the referring healthcare professional.

The Walton Centre Neuromuscular Service, Liverpool

The Walton Centre provides specialist neuromuscular care for myasthenia gravis and other nerve and muscle disorders.

The service runs several neuromuscular clinics and specifically lists dedicated myasthenia gravis clinics.

Its wider neuromuscular service also provides access to neurophysiology, specialist nursing, occupational therapy, physiotherapy and speech and language therapy where appropriate.

For someone living in North West England or nearby regions, The Walton Centre may therefore be one of the specialist neuromuscular services considered within the NHS referral pathway.

Leeds Teaching Hospitals Specialist Myasthenia Gravis Service

Leeds Teaching Hospitals has a specialist myasthenia gravis service within its neuromuscular neurology provision.

The service is led by neurologists with a specialist interest in neuromuscular disorders and MG.

The Leeds neuromuscular service also works with other disciplines, including respiratory teams, when additional expertise is needed.

University Hospitals Birmingham Neurology

University Hospitals Birmingham lists myasthenia gravis within its specialist neuroinflammation and neurology services.

Its referral guidance is particularly useful for understanding how tertiary neurology pathways can work.

The trust explains that direct primary-care referral is not available for most neurological subspecialty clinics. General neurology investigations and assessment are usually needed before onward referral to the appropriate subspecialty.

This is an important distinction. Asking to see an MG specialist does not always mean that a GP can refer directly to a named specialist clinic.

Is the Oxford Congenital Myasthenia Service a myasthenia gravis clinic?

The Oxford Congenital Myasthenia Service specialises in congenital myasthenic syndromes rather than the usual autoimmune form of myasthenia gravis.

This distinction is important.

Congenital myasthenic syndromes are inherited disorders affecting communication between nerves and muscles. Autoimmune myasthenia gravis results from an immune response affecting structures at the neuromuscular junction.

The Oxford service is a national referral centre for children and adults when a congenital myasthenic syndrome is suspected. Its investigations can include specialist electromyography and genetic testing.

Referral is made by a healthcare professional.

Someone searching for "myasthenia specialist Oxford" can therefore encounter this service even though its main purpose is different from a standard autoimmune MG clinic.

How do you get referred to a myasthenia gravis specialist in the UK?

The usual NHS route starts with a GP or an existing neurology team, but the exact pathway depends on where you live and the clinic you are trying to access.

If you have persistent or concerning symptoms that could have a neurological cause, a GP can assess the situation and consider whether specialist assessment is appropriate.

The NHS states that a GP may refer someone with symptoms suggestive of MG for specialist tests.

These investigations can include blood tests for MG-associated antibodies, nerve-function tests and imaging.

If you already see a neurologist, you can ask whether additional neuromuscular or MG expertise could be useful in your situation.

The receiving specialist service then decides whether the referral meets its criteria.

Can a GP refer directly to a specialist MG clinic?

A GP can refer directly to some specialist services, but this is not possible for every MG clinic.

For example, Queen Square lists the NHS e-Referral Service as a referral option for its neuromuscular service.

St George’s states that someone with a neuromuscular condition can ask their GP to refer them to its regional neuromuscular centre.

Other NHS services use a different structure. University Hospitals Birmingham explains that most of its neurological subspecialty clinics cannot be accessed directly from primary care. Assessment within general neurology usually comes first.

The practical route can therefore look like:

GP → general neurology → neuromuscular or MG specialist service

or, where local criteria allow:

GP → specialist neuromuscular service

If you already see a neurologist, onward referral may instead begin within your existing neurology team.

Can you ask for a second opinion about myasthenia gravis?

You can discuss the possibility of another specialist opinion with the healthcare professional responsible for your care.

A second specialist opinion may sometimes be considered when additional expertise is needed, when the diagnosis remains uncertain or when a particularly complex aspect of MG needs review.

Some specialist services explicitly provide tertiary or second-opinion expertise. Imperial College Healthcare, for example, describes its Muscle and MG Service as providing specialist opinions from north-west London and further afield.

A request does not automatically mean a particular specialist centre will accept the referral. The receiving service will consider its referral criteria and the reason for specialist review.

How do referral pathways differ across England, Scotland, Wales and Northern Ireland?

Referral systems vary across the UK because healthcare is organised separately in England, Scotland, Wales and Northern Ireland.

How does referral work in England?

In England, a GP can refer into neurology, while some specialist centres also accept referrals through the NHS e-Referral Service or other defined routes.

Whether general neurology assessment is needed first depends on the specialist service.

Local and specialist teams may also work together. Attending a tertiary MG centre does not necessarily mean all neurological care moves away from the local hospital.

How does referral work in Scotland?

Neuromuscular care in Scotland is supported by specialist services and the Scottish Muscle Network, which covers children and adults with neuromuscular disorders.

If highly specialised care is needed outside Scotland, National Services Scotland has a pathway for accessing certain specialist NHS services elsewhere in the UK.

These referrals are based on individual clinical need and normally require a specialist within NHSScotland and approval through the relevant NHS board process.

They are not a self-referral route.

How does referral work in Wales?

Neuromuscular care in Wales is organised through local health boards and regional specialist services.

For example, the South West Wales Neuromuscular Service accepts referrals from GPs, consultants and other healthcare professionals for conditions within its remit.

The appropriate route for myasthenia gravis depends on the local health board, existing neurological care and the type of specialist expertise required.

How does referral work in Northern Ireland?

Neurological care usually begins within local Health and Social Care services.

If highly specialised assessment or care is considered necessary but is not available within Northern Ireland, a consultant can make an Extra Contractual Referral request.

This allows the Strategic Planning and Performance Group to consider a transfer to a specialist provider elsewhere, normally elsewhere in the UK.

The process is led by the healthcare team rather than through self-referral.

When might specialist MG input be useful?

Specialist MG input may be considered when additional neuromuscular expertise is needed.

Situations can include:

• uncertainty about whether symptoms are caused by MG or another condition
• the need for specialist neurophysiology
• more complex antibody results
• predominantly ocular symptoms where the diagnosis remains unclear
• significant swallowing or speech difficulties
• respiratory involvement
• another specialist opinion
• questions involving pregnancy or another complex health condition
• situations where several specialties may need to work together

The exact reason for referral is individual.

Specialist review also does not automatically replace local neurological care. Specialist centres frequently work alongside local teams.

If swallowing is an important part of your experience, read more about difficulty swallowing with myasthenia gravis.

What should you prepare before a specialist MG appointment?

Preparing a concise record of your experience can make it easier to explain symptoms that change from hour to hour or day to day.

Useful information can include:

• when the symptoms first appeared
• which muscles seem affected
• whether symptoms change during the day
• whether repeated activity makes weakness more noticeable
• drooping of one or both eyelids
• episodes of double vision
• difficulties chewing
• changes in speech or voice
• swallowing difficulties
• neck, arm or leg weakness
• breathlessness
• current medicines and doses
• previous medicines used for MG
• previous antibody results
• previous nerve or muscle testing
• CT or MRI results
• previous neurology letters
• questions you want to discuss

You do not need to turn your experience into medical terminology. Describing what happens in everyday situations can also provide useful context.

For example, you might write down that your eyelid becomes harder to keep open in the evening, that speaking becomes more difficult after a long conversation or that chewing becomes harder partway through a meal.

The healthcare professional can then interpret those descriptions within the clinical assessment.

Why can documenting fluctuating MG symptoms be useful?

MG symptoms can change substantially over short periods, which can make them difficult to describe from memory during an appointment.

Experience themes captured through the mama health app repeatedly point to this challenge.

People living with MG have described difficulties such as:

• explaining changing symptoms clearly to healthcare professionals
• remembering how fatigue and strength have varied over time
• understanding which experiences are important to mention
• fitting everything they want to discuss into a short appointment
• wanting to hear how others describe similar everyday challenges

These themes matter because an appointment captures only a small part of daily life with MG.

A person may feel relatively strong while sitting in a clinic but have experienced much more noticeable weakness after activity, during meals or later in the day.

Writing down these experiences beforehand can provide a clearer picture of what you want to discuss.

These shared experiences are not medical evidence and cannot tell you what a particular symptom means. They provide another way to reflect on your own experience and discover questions that others have found useful to raise with healthcare professionals.

You can explore more real-life myasthenia gravis insights and practical support tools.

How can mama health help you prepare for a specialist appointment?

mama health provides a space to record and reflect on your experience with myasthenia gravis and explore educational information alongside experiences shared by others living with MG.

The mama health app can help you write down symptoms and everyday experiences in your own words. You can also organise information that you may want to discuss during an appointment.

Experience data available through mama health highlights recurring needs around explaining symptoms clearly, making sense of day-to-day changes and hearing how others navigate similar situations.

That can be useful before a specialist appointment because it may remind you of topics you wanted to raise.

For example, others living with MG have found it useful to describe:

• when weakness tends to become noticeable
• which activities seem particularly difficult
• how eye symptoms vary
• whether speaking or chewing becomes harder with continued use
• how symptoms affect work or everyday tasks
• questions about medicines
• what they would like clarified at their next appointment

Seeing how someone else describes an experience does not mean the same explanation applies to you. Individual experiences vary.

mama health does not determine whether you need referral to a specialist, interpret symptoms as a diagnosis or recommend a particular medical treatment.

It offers educational information and a structured way to reflect on information that you may choose to discuss with a healthcare professional.

Explore myasthenia gravis support from mama health.

What medical information is useful to bring to an MG appointment?

Previous investigation results and an up-to-date medicines list can be particularly useful.

If available, consider bringing copies of:

• previous neurology letters
• acetylcholine receptor antibody results
• MuSK or other antibody results
• neurophysiology results
• CT or MRI reports
• hospital discharge letters
• a current prescription list
• details of medicine allergies or previous reactions

King’s College Hospital specifically advises bringing previous letters and results if you have already been assessed at another hospital.

If you want to understand the role of different antibodies before your appointment, see our guide to AChR, MuSK and LRP4 antibodies in myasthenia gravis.

Why is a complete medicines list important with myasthenia gravis?

A complete medicines list is useful because some medicines can worsen neuromuscular weakness or require additional consideration in MG.

Include prescription medicines, medicines bought without a prescription and supplements.

Do not stop a prescribed medicine because it appears on an online list. The risks and benefits can differ from person to person.

Instead, a healthcare professional or pharmacist can review whether any additional precautions are appropriate.

Read more in our guide to medicines that may require additional consideration with myasthenia gravis.

What questions could you take to an MG specialist appointment?

Preparing questions in advance can make it easier to remember what you wanted to discuss.

Depending on your situation, possible questions include:

• Which type of myasthenia gravis is being considered?
• What do my antibody results mean?
• Are any further neurophysiology tests being considered?
• Is my MG mainly affecting my eyes or other muscle groups as well?
• Who should I contact if my symptoms change between appointments?
• Which changes would require urgent medical attention?
• Are any of my current medicines relevant to MG?
• Will my local neurology team remain involved?
• When is another specialist review usually considered?
• Is there anything useful for me to record before the next appointment?

These are examples of questions others may find useful. They are not recommendations about what care you personally require.

How long does an NHS referral to an MG specialist take?

There is no single UK waiting time for a specialist MG appointment.

Waiting times can differ by NHS organisation, urgency, local neurology capacity and whether the referral is for general neurology or a tertiary specialist service.

The referring healthcare professional can explain which service the referral has been sent to. The receiving hospital can usually provide information about appointment administration once the referral has been accepted.

If symptoms significantly change while you are waiting, contact the healthcare service responsible for your care rather than waiting for the specialist appointment.

What happens if there is no specialist MG clinic near you?

You do not necessarily need to live close to a named MG centre to receive neurological care.

Local neurologists can manage many aspects of MG. When additional expertise is needed, they may be able to request advice or referral from a regional or tertiary neuromuscular service.

In some situations, care can therefore involve both a local neurology service and a more distant specialist centre.

This can be particularly relevant for rare conditions because specialist expertise tends to be concentrated in larger neurological centres.

When should breathing or swallowing problems be treated as an emergency?

Severe or rapidly worsening breathing or swallowing difficulties require urgent medical attention.

MG can sometimes cause severe weakness involving the muscles required for breathing. This is known as a myasthenic crisis.

The NHS advises calling 999 for an ambulance immediately if you develop worsening severe breathing or swallowing difficulties.

Do not wait for a routine neurology appointment or use an app to assess an emergency.

For more educational information, read our guide to myasthenia gravis symptoms and myasthenic crisis.

What is the main thing to know about finding an MG specialist in the UK?

The main thing to know is that specialist MG expertise exists across the UK, but access routes vary between NHS services.

Some centres have dedicated myasthenia gravis clinics. Others provide MG expertise through a broader neuromuscular or neuroimmunology service.

A GP may be able to refer directly in some areas. Elsewhere, assessment in general neurology is normally the first step.

If you already have neurological care, your existing team can explain whether an additional specialist opinion may be appropriate and which service fits the reason for referral.

Preparing your medical information and writing down what happens between appointments can also make it easier to explain an experience that may fluctuate considerably from one day to another.

mama health can provide an additional space for reflecting on those day-to-day experiences, exploring educational information and seeing the types of questions and challenges others living with MG have described.

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This content is informational and not a medical device.

mama health offers information and support and does not replace a doctor.

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• NHS — Myasthenia gravis: NHS information confirms that MG is a long-term condition causing muscle weakness, describes common symptoms and explains that a GP may refer someone for specialist testing.
• NHS — Myasthenia gravis symptoms: NHS guidance states that severe or worsening breathing or swallowing difficulties require emergency medical attention.
• University College London Hospitals — Neuromuscular Disease Service, Queen Square: the service treats myasthenia gravis and other neuromuscular-junction disorders and lists the NHS e-Referral Service as a referral route.
• St George’s University Hospitals — Myasthenia Clinic and Neuromuscular Disorders: St George’s documents a weekly dedicated MG clinic and states that GP referral can be requested for its regional neuromuscular centre.
• King’s College Hospital — Muscle and Myasthenia: King’s documents its dedicated service, MG expertise, routine referral process and advice to bring previous letters and results.
• Imperial College Healthcare — Muscle and MG expertise: Imperial documents specialist myasthenia gravis expertise and second-opinion work within its Muscle and MG Service.
• The Walton Centre — Neuromuscular Disorders: The Walton Centre lists dedicated myasthenia gravis clinics alongside specialist neuromuscular, neurophysiology and multidisciplinary services.
• University Hospitals Birmingham — Neurology referrals: the trust lists myasthenia gravis within its neurological subspecialties and explains that general neurology assessment is required before referral to most subspecialty clinics.
• Oxford University Hospitals — Congenital Myasthenia Service: Oxford confirms that its national service is for suspected congenital myasthenic syndromes and that referrals are made by healthcare professionals.
• National Services Scotland, NHS Wales and HSC Northern Ireland: official guidance describes specialist and cross-border referral arrangements in Scotland, regional neuromuscular referrals in Wales and consultant-led transfer arrangements where specialist care is unavailable in Northern Ireland.
• mama health — MG insights and real-life tools: existing mama health material identifies recurring experience themes around explaining symptoms, changing fatigue and strength, and communicating during short medical appointments.

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