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Prednisone-induced worsening of neuromuscular function in myasthenia gravis

Department of Neurology (Drs. Milner-Brown and Mirka), Children's Hospital of San Francisco, and the Department of Neurology (Dr. Miller), University of California at San Francisco, San Francisco, CA.

In patients with myasthenia gravis who received single doses of prednisone orally (40 to 100 mg), we found acute inhibition of neuromuscular function as manifest by increased decremental responses to repetitive nerve stimulation, reduced twitch tension, and lowered maximum voluntary contraction strength. The time course of these changes correlated with plasma methylprednisolone levels, implying direct drug effects on neuromuscular function.

Address correspondence and reprint requests to Dr. Miller, Department of Neurology (OPR 613), Children's Hospital of San Francisco, 3700 California Street, San Francisco, CA 94119.

Presented in part at the annual meeting of the American Academy of Neurology, Boston, MA, April 1984.

Supported by The Muscular Dystrophy Association of America and the Zimmerman Fund of the Children's Hospital of San Francisco.

Accepted for publication September 27, 1986.

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