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August 1971

Respiratory Arrest in Myasthenia Gravis With Colistimethate Therapy

Author Affiliations

Iowa City
From the Department of Neurology, University Hospitals, Iowa City.

Arch Neurol. 1971;25(2):141-144. doi:10.1001/archneur.1971.00490020059006

A 70-year-old man with myasthenia gravis received a single intramuscular injection of colistimethate sodium (150 mg) for a urinary tract infection. He developed a respiratory arrest with a complete flaccid paralysis three hours later. All muscles but those associated with respiration improved rapidly following intramuscular neostigmine methylsulfate (2 mg) and intravenous edrophonium chloride (10 mg) administration. A combination of ventilation support and anticholinesterase therapy brought about recovery in 11 days. Carbenicillin effectively eradicated the Pseudomonas infection without causing neuromuscular impairment.

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