HAZARDS OF NEOSTIGMINE IN PATIENTS WITH NEUROMUSCULAR DISORDERS

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Abstract
In a 57-yr-old female with dystrophia myotonica, attempts to reverse residual non-depolanzmg block with neostigmine 1.0 mg were only partially effective and the administration of a further dose (0.5 mg) produced long-lasting muscle weakness. The train-of-four response of this patient resembled that of a depolarizing block and suggested an alteration in the electrical properties of the muscle membrane A 50-yr-old male with a 30-yr history of progressive muscle dystrophy, exhibited a tonic response to neosugmine in the evoked mechanomyograM.During recovery from partial neuromuscular block. It is concluded that the type of reaction to neostigmine in patients with neuromuscular disease is unpredictable.