INTRAVENOUS NEOSTIGMINE IN DIAGNOSIS OF MYASTHENIA GRAVIS

Abstract

Neostigmine, 0.5 mg., given intraven. in a timed 1 min. period, produces a more rapid and complete diagnostic response in myasthenics than does the standard 1.5 mg. intramusc. test of of Schwab and Viets. Usually 20 to 60 min. are required for often sub-maximal responses to intramusc. neostigmine, whereas clear-cut improvement is seen in from 15 sec. to 5 min. after the intraven. dose. Unlike the intramusc. test, atropine is not given with intraven. neostigmine but is always kept at hand for immediate subcut. or intraven. use should any parasympathetic side-effects appear. Intraven. neostigmine has been given to several hundred patients without any serious reactions in the dosage range used, and it has given objective diagnostically positive responses in 21 out of 24 cases of myasthenia gravis seen by the author in a 5-yr. period.