Unlocking Myasthenia gravis

Episode 25 – Lorenzo Maggi and Nils Erik Gilhus discuss triggers of exacerbations in MG, focusing on how to recognize and manage worsening symptoms in clinical practice. They highlight common triggers and the challenges of distinguishing normal fluctuations from true exacerbations of the disease, and reflect on the importance of prevention, patient education, and individualized care.

Episode 24 – Nils Erik Gilhus and Elena Cortés‑Vicente share their clinical perspective and experience on the evolving landscape of MG in older adults, highlighting the rising incidence after age 65 and the distinct clinical features seen in this population. They discuss the challenges of managing MG alongside comorbidities and polypharmacy, and examine current and emerging therapies, underscoring the importance of preserving quality of life and improving outcomes for older patients.

Episode 23 – Sophie Lehnerer joins Nils Erik Gilhus to discuss how chat-based digital communication and remote symptom monitoring can support follow-up in MG. They describe how symptom tracking using validated outcome measures and optional wearable and respiratory metrics can support needs-based reviews, strengthen continuity of care, and provide deeper clinical insight into disease burden and treatment response. This approach complements in-person visits and addresses practical and resource considerations in routine MG care.

Episode 22 – Maria Da Silva Leite and Nils Erik Gilhus examine how MG treatment approaches are evolving, with a focus on antibody-defined subtypes, treatment goals, and long-term disease control. They highlight how improved disease characterization is increasingly shaping therapeutic decision-making and consider the balance between efficacy and treatment burden, as well as how emerging targeted therapies and biomarkers may enable more selective, patient-centered management in the future.

Gil Wolfe joins Nils Erik Gilhus to discuss thymectomy in people with MG, with a focus on indications, patient selection, and optimal timing. They reflect on which people with AChR-positive generalized MG are likely to benefit from surgery, how age and disease subtype influence surgical decision-making, and why timing, minimally invasive surgery, and close neurologist–surgeon collaboration are critical to optimizing outcomes.

Episode 20 – John Vissing discusses what patients with MG often leave unsaid in clinic, including why symptoms may not be volunteered without targeted questioning, how patients prioritize functional impact over measured muscle strength, and the hidden psychological burden that shapes treatment satisfaction. Drawing on survey data and clinical experience, the discussion highlights how asking the right questions can reveal unmet needs, fears of exacerbation, and concerns that rarely surface unprompted.

Episode 19 – Henry Kaminski and Nils Erik Gilhus reflect on how MG care has evolved. From the impact of targeted therapies, such as complement and FcRn inhibitors, to breakthroughs on the horizon, they unpack why patients are doing better today, the challenges that remain, and whether emerging strategies could lead to lasting remission.

Episode 18 – Digital innovation is transforming the way we manage MG. Henry Kaminski joins Nils Erik Gilhus to discuss the role of AI, remote monitoring, and patient-driven tools in shaping future care. Kaminski shares insights on how these technologies can improve disease tracking, strengthen patient–clinician interaction, and support the delivery of expert care across fragmented health systems.

Episode 17 - Tobias Ruck joins Nils Erik Gilhus to share his experience managing a compelling case involving a patient with recurrent crises and respiratory failure. Together, they discuss how to identify early red flags and emphasize the importance of timely intervention before respiratory compromise becomes critical.

Episode 16 – Professor Nils Erik Gilhus welcomes Professor Francesco Saccà to discuss quality of life in people with MG, including the outsized impact of unpredictable symptoms, striking the right balance when informing patients about the risk of myasthenic crisis, and how encouraging patients to regularly self-report symptoms can influence both wellbeing and treatment planning.