Drs. Jonathan Strober and Diana Castro examine the diagnostic approach to generalized myasthenia gravis (gMG), with a focus on age-related differences in clinical presentation. They describe early signs in pediatric patients—such as ptosis and impaired extraocular movements—and contrast these with the fluctuating fatigue, bulbar involvement, and proximal muscle weakness more commonly seen in adults. The discussion includes practical strategies for diagnostic confirmation and highlights the role of antibody testing and the limitations of electrophysiologic studies in children. The faculty emphasize the importance of keeping MG in the differential diagnosis to minimize delays in recognition and treatment.