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May 25, 1946

Clinical Notes, Suggestions and New Instruments

JAMA. 1946;131(4):285-286. doi:10.1001/jama.1946.02870210021006

THE USE OF NEOSTIGMINE IN THE TREATMENT OF THE GUILLAIN-BARRÉ SYNDROME  J. ORDIE SHAFFER, M.D. MinneapolisThe Guillain-Barré syndrome has recently received increasing attention and is more frequently being differentiated as a distinct entity from similar conditions such as poliomyelitis. The use of neostigmine by Kabat and Knapp1 in the treatment of poliomyelitis prompted the use of neostigmine in this case of the Guillain-Barré syndrome.Neostigmine methylsulfate (1: 2,000 solution) was given hypodermically in dosages varying from 2 to 8 cc. daily, with an average of 5 to 6 cc. being given in divided doses of 1 to 2 cc. (0.5 to 1 mg.) at two to three hour intervals. The action occurs rapidly, so that within fifteen minutes muscle spasm and incoordination are measurably reduced. The decrease in "proprioceptive

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