Thomas M Bosley
Saudi Arabia
Research Article
Ocular Neostigmine Drops for Diagnosing Myasthenia Gravis
Author(s): Mustafa A Salih, Mohamed A Salih, Ali A Mustafa, Darren T Oystreck, Kamal M Attia, Sara M El-Sadig, Ahlam A Hamed, Waseem M Hajjar and Thomas M BosleyMustafa A Salih, Mohamed A Salih, Ali A Mustafa, Darren T Oystreck, Kamal M Attia, Sara M El-Sadig, Ahlam A Hamed, Waseem M Hajjar and Thomas M Bosley
Introduction: A variety of tests have been devised for the diagnosis of myasthenia gravis (MG). The best known
of these (Tensilon test, using intravenous edrophonium chloride) may cause serious complications (bradycardia and
syncope) dictating cardiac monitoring during the procedure. Ocular neostigmine drops, a simple procedure, may
significantly reduce the risk of diagnostic testing for possible MG.
Method: To investigate its efficacy, the miotic effect of neostigmine was explored using 30 rabbits. One drop of
sterile neostigmine solution (2.5 mg/ml) was instilled into the right eye (RE) of each rabbit using the left eye (LE), which
received sterile normal saline, as control. Serial assessments of pupillary size were done. One drop of neostimine was
instilled daily for 7 days to investigate its safety. Six patients (aged 4.5–55y,.. View More»
