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Understanding myasthenia gravis and advances in its management

Published on August 31, 2023   38 min

Other Talks in the Series: The Immune System - Key Concepts and Questions

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0:00
Hello. My name is Henry Kaminski. I'm a professor at George Washington University, and I've studied myasthenia gravis for my entire medical career. Today, I'll be talking to you about understanding of myasthenia gravis and recent advances in its management.
0:19
A brief outline. I'm going to discuss the clinical presentation and how myasthenia gravis is diagnosed, introduce the physiology of myasthenia gravis, and the standard of care and emerging therapies, which are very exciting in our disease right now.
0:37
Let me first start with one of the original descriptions of myasthenia gravis by Sir Thomas Willis, and allow me to read this. "At this time I have under my charge a prudent and honest woman, who for many years has been obnoxious to this sort of spurious palsy. Not only in her members, but also in her tongue. She for some time can speak freely and readily enough, but after she has spoke long or hastily or eagerly, she's not able to speak a word, but becomes as mute as a fish. Nor can she recover the use of her voice under an hour or two." This description has many key features of myasthenia gravis. The first one appreciates that there are periods of normality. She can speak freely and readily, but then she develops fatigue to near muteness, or entire muteness, which I certainly have seen in some patients during my career. And then the weakness recovers. A woman is described, and so young women have a propensity to develop this disease, compared to men, in early years. And Willis points out that she's prudent and honest, so there's a distinction with psychiatric conditions. Sadly, sometimes, myasthenia gravis is confused with and also delays the diagnosis of actual myasthenia gravis.

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