PMID: 123143Mar 1, 1975Paper

A hypothesis to account for the Mary Walker phenomenon

Annals of Internal Medicine
B M Patten


Certain myasthenic patients show that their skeletal muscles produce a substance during ischemic exercise which, when released into the circulation, increases muscle weakness. This phenomenon has been named after Mary Walker, the physician who popularized its demonstration. It is suggested that ischemic exercise produces lactic acid that binds calcium, reducing ionized and total serum calcium. The decreased calcium has an adverse effect on skeletal muscle function especially in patients with myasthenia gravis, where neuromuscular function is often so precarious it may be interrupted by weak inhibitors.


Jan 26, 1978·The New England Journal of Medicine·D B Drachman
Jan 1, 1976·Annals of the New York Academy of Sciences·T NambaD Grob
Aug 3, 2012·Clinical Neurology and Neurosurgery·Michal HaranMordechai Shtalrid
Dec 8, 2007·Journal of Clinical Anesthesia·Melissa A Brodsky, Jennifer A Smith
Aug 18, 1999·Arquivos de neuro-psiquiatria·F M CunhaL C Werneck
Dec 29, 2000·Medicine and Science in Sports and Exercise·J J Leddy, J G Chutkow

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