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William W. Hofmann, MD

Arch Neurol. 1977;34(6):356-360.

Abstract
• Tests were made in vitro of the action of prednisolone on nerve backfiring, muscle twitches, tetanus decay rates, miniature end-plate potential amplitude and frequency, and the block induced by curare, hemicholinium, and excess magnesium. At about 0.1mM concentration, the steroid showed no "veratrinic" or decurarizing action, and the probability of transmitter release was not increased in 10mM Mg⁺⁺. Moreover, when acetylcholine stores were depleted in hemicholinium, there was no evidence of repair by steroid. The results are taken to mean that prednisolone and congeners do not owe their therapeutic efficacy in myasthenia to actions at the neuromuscular junction. It is therefore concluded that the clinical benefits from steroids are related to systemic, possibly immunosuppressive effects.

Author Affiliations
From the Department of Neurology, Veterans Administration Hospital, Palo Alto, and Stanford University School of Medicine, Stanford, Calif.

Footnotes
Accepted for publication Jan 10, 1977.

Reprint requests to Department of Neurology, Veterans Administration Hospital, 3801 Miranda Ave, Palo Alto, CA 94304 (Dr Hofmann).

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