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June 29, 1970

Myasthenia Gravis Syndrome Associated With Trimethadione

Author Affiliations

From the Epilepsy Center, University of Wisconsin Medical Center, Madison.

JAMA. 1970;212(13):2262-2263. doi:10.1001/jama.1970.03170260058019

A myasthenic reaction in an 8-year-old girl developed within a few months during treatment of petit mal seizures with trimethadione. Progressive bulbar weakness culminated in a crisis with respiratory failure following a major convulsion. Initially, large doses of neostigmine (Prostigmin) methylsulfate were required, but a complete remission occurred within six months after trimethadione was withdrawn. This case is remarkably similar to the case described by Peterson,1 and supports his hypothesis that an auto-immune response to trimethadione was the responsible mechanism.