In this episode I explore the autoimmune neurological disorder, myasthenia gravis. I review its classical manifestations as ocular and generalised myasthenia, and I highlight its complications such as refractory myasthenia and myasthenic crisis.
The podcast also discusses the pathogenesis and triggers of the disease, its various mimics, and its indispensable investigations. I also review its treatments which include acetylcholine esterase inhibitors, steroids, immunosuppressants, IVIg and plasma exchange.
I complement the podcast with historical anecdotes regarding the discoveries, frequently serendipitous, of the various treatments of myasthenia gravis. This narrative includes such stories as Mary Walker’s miracle of Alfege’s, the dream insight of Otto Loewi, the mystery of the headless torso in the Thames, and the role played by the Calabar bean in the history of myasthenia gravis. Other relevant historical themes were the role played by Alfred Blalock in introducing thymectomy for myasthenia gravis, and the first serendipitous self-treatment of myasthenia gravis by medical student Harriet Edgeworth.
I rely on such illustrative patient memoirs as those of Kemi Olawaiye-Dampson titled Living with Myasthenia Gravis, of Howard Caras titled Permanent Detour, and of Ronald Henderson titled Attacking Myasthenia Gravis.
I also cited such enlightening academic sources as Coping with Myasthenia Gravis, by Aziz Shaibani and colleagues, and The Spark of Life by Frances Ashcroft.
