INTRAVENOUS NEOSTIGMINE IN DIAGNOSIS OF MYASTHENIA GRAVIS
Authors: J E TETHER
Journal: Annals of Internal Medicine (1948)

Article1 December 1948INTRAVENOUS NEOSTIGMINE IN DIAGNOSIS OF MYASTHENIA GRAVISJ. E. TETHER, M.D.J. E. TETHER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-29-6-1132 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe diagnosis of myasthenia gravis has been made with ever increasing frequency since 1935 when Walker1 demonstrated the remarkable therapeutic effect of neostigmine and Viets and Schwab2 described its diagnostic use.Prior to 1942 there were only four cases on our records. In the past five years 23 more have been diagnosed. These cases will be reported later. The purpose of this paper is to present a modification of the neostigmine diagnostic test described by Schwab and Viets.3Their test consists of the intramuscular injection of 1.5 mg. of neostigmine methylsulfate combined with 0.6 mg. of atropine sulfate in a...Bibliography1. WALKER MB: Case showing the effect of prostigmine on myasthenia gravis, Proc. Roy. Soc. Med., 1935, xxviii, 759. CrossrefGoogle Scholar2. VIETSSCHWAB HRRS: Prostigmine in the diagnosis of myasthenia gravis, New England Jr. Med., 1935, ccxiii, 1280. CrossrefGoogle Scholar3. SCHWABVIETS RSHR: Prostigmine test in myasthenia gravis, New England Jr. Med., 1938, ccix, 266. Google Scholar4. AESCHLIMANNREINERT : Pharmacological action in some analogues of physostigmine, Jr. Pharmacol. and Exper. Therap., 1931, xliii, 413-444. Google Scholar5. GOODMANBRUCKNER LAWJ: The therapeutics of prostigmine: a warning concerning its oral use based on a personal experience, Jr. Am. Med. Assoc., 1937, clxxviii, 965. CrossrefGoogle Scholar6. BENNETTCASH AEPT: Myasthenia gravis. Curare sensitivity; a new diagnostic test and approach to causation, Arch. Neurol. and Psychiat., 1943, xlix, 537. CrossrefGoogle Scholar7. BENNETTCASH AEPT: Myasthenia gravis and curare sensitivity in Diseases of the Nervous System, Physician's Post-Graduate Press, 1943, iv, 299. Google Scholar8. MCINTYRE AR: Curare, 1947, The University of Chicago Press, p. 196. Google Scholar9. VIETS HR: Myasthenia gravis treated with large doses of neostigmine methylsulfate, intravenously and intramuscularly and with neostigmine bromide orally, Am. Jr. Med Sci., 1944, ccviii, 701-830. CrossrefGoogle Scholar10. VIETS HR: Diagnosis of myasthenia gravis in patients with dysphagia, Jr. Am. Med. Assoc., 1947, cxxxiv, 988. Google Scholar11. TETHER JE: Myasthenia gravis. A case discussion with preliminary report of use of intravenous neostigmine in diagnosis of myasthenia gravis, Quart. Bull., Indiana Univ. Med. Center, 1947, ix, 3. Google Scholar12. MERRILL GG: Neostigmine toxicity, Jr. Am. Med. Assoc., 1948, cxxxvii, 362. CrossrefGoogle Scholar13. TETHER JE: Correspondence, Jr. Am. Med. Assoc., 1948, cxxxvii, 1078. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Indianapolis, Indiana*Received for publication November 28, 1947.From the Department of Medicine, Indiana University Medical Center.The author expresses his appreciation to the Hoffmann-La Roche Company for generously furnishing most of the neostigmine ("Prostigmin") used in this series.†Addendum: Since the writing of this paper, a fatality, presumably due to the intramuscular injection of 1 c.c. (0.5 mg.) of neostigmine, has been reported.12 That this was probably an example of unusual individual susceptibility was mentioned by Dr. Merrill and further stressed by me in a letter to the Editor of the Journal of the American Medical Association.13 In this letter immediate use of atropine, intramuscularly or intravenously, for any untoward reaction to neostigmine was reëmphasized. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byIntravenous Neostigmine Test for Diagnosis of Ocular Myasthenia GravisTherapy of Myasthenia GravisPharmacological Considerations in the Treatment of Myasthenia GravisMyasthenia gravisAbnormalities in neuromuscular transmission, with special reference to myasthenia gravisMyasthenia GravisDiseases of MusclesTHE ASSOCIATION OF GRAVES' DISEASE WITH MYASTHENIA GRAVIS, WITH A REPORT OF FIVE CASES*GEORGE LEVY, M.D., W. R. MEADOWS, M.D., ROLF M. GUNNAR, M.D.Myasthenia gravis 1 December 1948Volume 29, Issue 6Page: 1132-1138KeywordsAtropineIntramuscular injectionsMyasthenia gravis ePublished: 1 December 2008 Issue Published: 1 December 1948 PDF downloadLoading ...