—Dr Rowland has brought to our attention the articles of Johns et al1 and McQuillen,2 which represent problems similar to those seen in our patient. In addition, he voices his concern about terminology. The cases cited by Dr Rowland are, however, different from our patient in a number of ways; most of the patients had ocular or bulbar signs early and/or episodic disease.3-5 In addition, some had conditions that we now recognize as congenital myopathy6 or inflammatory myopathy.7The patients described by McQuillen represent an interesting family with early onset of proximal weakness and a minimal response to anticholinesterase drugs. Should any neuromuscular disease that responds to cholinesterase drugs be called myasthenia gravis? Many neuromuscular diseases with weakness, including amyotrophic lateral sclerosis, respond in some degree to anticholinesterase drugs. At the present time, that does not mean that these patients have myasthenia gravis. In time
Husain F, Ryan NJ, Hogan GR. Life Before MEDLINE: Myasthenia Gravis, Muscular Dystrophy, and Myasthenic Myopathy-Reply. Arch Neurol. 1989;46(10):1048. doi:10.1001/archneur.1989.00520460022007
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