Miriam Freimer, MD: I'm the director of the myasthenia gravis clinic at Ohio State, and we see patients primarily in that clinic with myasthenia gravis. And we have several ongoing and new trials that are starting looking at novel treatments for this disease.

Myasthenia gravis is a disease that affects the muscle-nerve connection, so it's affecting the ability of the nerve to communicate adequately with the muscle. And it is a disease of the immune system, where a portion of the immune system is attacking a portion of the muscle and that portion, that part is what recognizes the message from the nerve. And when patients have this disease, their symptoms can fluctuate. They may have weakness of the eyes and the mouth, of the arms and the legs. And it may get worse when they're tired, it may get worse when they're sick with another illness. But fortunately, patients with myasthenia gravis usually respond very well to therapies.

When I'm treating patients who have immune-mediated diseases of the muscle and nerves such as myasthenia gravis or dermatomyositis or CIDP, I understand that these are scary diagnoses for patients. 

And I try my best to get patients to understand as much as possible about these diseases. 

I try to go through the treatments that are available for the patient, so the patient can feel a sense of control and understanding about what might happen now and in the future. 

So one of the things that patients frequently ask is, "Is this an inherited process?" And what I try to explain to patients is that there's a lot about the cause or the etiology of these diseases that we don't know. But the major question for a lot of people is, "Can my children get this disease?" And unfortunately this is something that we really don't know. We know that there is a tendency for immune-mediated diseases, or auto-immune diseases, to run in families, but we don't know how to identify who might get this and who's at risk. And this is something that there is a lot of research going on at a basic science level to understand better.

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The Ohio State University Wexner Medical Center]