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Myasthenic Syndrome Associated With Antibiotics
Michael P. McQuillen, MD;
Harvey E. Cantor, MD;
James R. O'Rourke, MD
Arch Neurol. 1968;18(4):402-415.
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ANTIBIOTICS produce weakness by interfering with neuromuscular transmission. Apnea in experimental animals was observed first in 1941 with tyrothricin, the first antibiotic tested for clinical application.1 In 1956, the first case of prolonged apnea in man was reported after intraperitoneally infected neomycin sulfate.2 Since 1956, a syndrome characterized by respiratory weakness, flaccid paralysis, and pupillary and visual changes has been recognized in association with a number of antibiotics.3-50 As defined, this "myasthenic syndrome" occurs in patients who do not have myasthenia gravis, although some myasthenics become weaker when given certain antibiotics.51 Recent reviews of antibiotic toxicity do not emphasize this syndrome52-54 Electromyographic (EMG) studies were mentioned in only four patients. In one, neuromuscular transmission and nerve conduction velocities were normal.49 A "currarelike"30 or nondepolarizing34,50 effect occurred in the others. In one patient50 the block was not altered by edrophonium chloride.
Profound
. . . [Full Text PDF of this Article]
Author Affiliations
Lexington, Ky
From the departments of neurology and medicine, University of Kentucky Medical Center, Lexington.
Footnotes
Submitted for publication June 26, 1967; accepted Aug 15.
Read before the 92nd annual meeting of the American Neurological Association, Atlantic City, NJ, June 14, 1967.
Reprint requests to Department of Neurology, University of Kentucky Medical Center, Lexington, Ky 40506 (Dr. McQuillen).
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