This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on ISI (1)  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in this journal  Topic Collections  • Immunologic Disorders  • Diagnosis  • Myasthenia Gravis  • Neuromuscular diseases  • Neuro-ophthalmology  • Alert me on articles by topic

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

In reply

We appreciate the comments from Drs Liu and Chan regarding our article describing a case of ocular myasthenia gravis with anti-MuSK antibodies. We are in agreement that a Tensilon test is a useful test in the diagnosis of myasthenia and could have been performed during her evaluation. While the Tensilon test is highly sensitive, it does lack specificity and is associated with a variety of potential adverse events, including symptomatic bradycardia with hypotension.¹ Our patient experienced generalized "shakiness" on low doses of pyridostigmine bromide, providing another reason to avoid administering Tensilon.

Some experts recommend that objective serologic or electrophysiologic evidence of myasthenia gravis be documented prior to the use of long-term immunosuppression or thymectomy so that there can be no question of the diagnosis at a later time when the clinical signs may no longer be evident. While results from a Tensilon test can be dramatic, milder degrees . . . [Full Text of this Article]

AUTHOR INFORMATION

James B. Caress, MD; Christopher H. Hunt, MD

RELATED ARTICLE

Bread-and-Butter in Diagnosis of Myasthenia Gravis
Alice Y. K. Chan and David T. L. Liu
Arch Neurol. 2005;62(12):1939.
EXTRACT | FULL TEXT