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Living with Congenital myasthenic syndrome 4C

A rare condition affecting the connection between nerves and muscles, causing weakness that starts early in life.

Understanding Congenital myasthenic syndrome 4C

Congenital myasthenic syndrome 4C is a rare condition that affects the connection between nerves and muscles.

It causes muscle weakness that starts early in life and can range from mild to more severe. Tests show a shortage of a substance called AChR at the connection point between nerves and muscles. It is caused by genetic factors and can be inherited.

Signs & symptoms

Symptoms vary from person to person. GARD lists these among the most common:

  • Drooping upper eyelid (ptosis)
  • Weakness that worsens with use
  • Weak eye muscles (ophthalmoparesis)
  • Easy tiring (fatigability)
  • Feeding difficulties
  • Low muscle tone (hypotonia)

Not everyone has every symptom. GARD's list comes from the Human Phenotype Ontology.

Diagnosis

  1. Talk with your doctor

    Share the symptoms you've noticed, when they started and your family health history. Notes and photos can help.

  2. See a specialist

    Your doctor may refer you to a specialist who knows rare conditions.

  3. Ask which tests can help

    Your care team will decide which exams and tests can confirm the diagnosis.

Care & treatment

Care team
A doctor familiar with rare conditions, plus specialists as needed
Expert care
Ask about multidisciplinary care centers for rare conditions
Treatment
GARD doesn't list specific treatments for this condition. Your care team will tailor care to your symptoms.
Research
Clinical trials and observational studies may be options. See the research section below.

General information, not medical advice. Your care team makes the decisions.

Everyday life

Living with a rare condition is easier with support.

  • Connect with rare disease patient organizations for support
  • Keep notes on symptoms, changes and questions for appointments
  • Ask about patient registries that help research
  • Look into financial aid and travel resources for care visits
Bring these questions to your next doctor visit
Which gene is involved, and would genetic testing help our family?
How might muscle weakness change as my child grows?
Which specialists should be involved in my child's care?

Quick facts

InheritanceAutosomal Recessive

GARD says it is caused by genetic factors. It is autosomal recessive, meaning a child inherits a changed copy of the gene from each parent.

Also known as: cms id; cms1d; cms4c; congenital myasthenic syndrome 4c associated with acetylcholine receptor deficiency; congenital myasthenic syndrome type 4c; congenital myasthenic syndrome type id

Patient organizations

Rare-disease groups that can help

Source: NIH GARD · Congenital myasthenic syndrome 4CGARD ID 10108 · GARD page updated September 2026 · Plain-language summary by Know Rare; editorial review pending. General information, not medical advice.

You are more than your diagnosis

Perspectives from people navigating life with Congenital myasthenic syndrome 4C.

Explore the Congenital myasthenic syndrome 4C blog

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HealthSpark

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