[alice md]

Osserman described myasthenia in 1200 patients in the 60s.

he learned about this illness from those who knew it best- the patients.

much of what he has observed and written has apperntly been lost.


so I thought I would copy some parts of it for you-

p.500-inspiratory distress may be the first recongnized sign of MG, whether the dyspnea is primarily inspiratory or expiratory depends on the muscle groups involved. With diaphragmatic involvement the dyspnea is inspiratory, when the intercostal muscles are involved it is primarily expiratory. In milder cases dsypnea occurs only during exercise. Maximal breathing capacity diminishes out of proportion to the decrease in vital capacity.

Sensory changes both in involved and uninvolved muscle groups are frequently present in myasthenia gravis. Patients usually have little discomfort in the morning, but the pain becomes more severe as the day progresses. Frequently rest of anticholine esterase medications, will give relief. The pain in part may be due to the extra effort required to maintain posture with the weak muscles. Other sensory changes are headaches, ocular pain and parasthesias of the face tounge lips or extremities. About 14% of patients will experience sensory symptoms at one time or the other..


this seems to be the part, modern neuros remember best-

p. 530- Specialists in MG, are often called upon for advice to help in the care of the patient during intercurrent disease…as is common in other chronic disease states, the severe hospital cases described in previous sections, often give a skewed picture as to the severity of the disease in the total myasthenic population. The overwhelming majority of myasthenics lead a useful productive life with only minor deficits… Any chronic disease with this impact seriously alters the fabric of life with resulting emotional and social maladjustments.

alice