Skip to main content
Log in

Efficacy of intranasal administration of neostigmine in myasthenic patients

  • Original Communications
  • Published:
Journal of Neurology Aims and scope Submit manuscript

Summary

The efficacy of intranasally administered neostigmine was tested in 22 patients with generalized myasthenia gravis (MG). Topical therapy to the highly vascularized oropharynx proved to be quickly effective in 5–15 min both clinically and electrophysiologically. Twenty-eight MG patients were then recruited from different centres and their morning doses of oral pyridostigmine were substituted with intranasal neostigmine over a period of 2 or 3 weeks. Intranasal neostigmine proved to be equally efficacious in this regimen. No side-effect was noted even in 4 patients treated in this way for 1 year. Intranasal administration of anti-acetylcholinesterase may be very beneficial: (1) for patients with irregular absorption of oral doses; (2) early in the morning and every time a fast and temporary effect is needed; (3) in bulbar impairment and emergencies, in which a handy atomizer may be life-saving.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Aquilonius SM, Eckernas SA, Hartvig P, Lindstrom B, Osterman PO, Stalberg E (1983) Clinical pharmacology of pyridostigmine and neostigmine in patients with myasthenia gravis. J Neurol Neurosurg Psychiatry 46:929–935

    Google Scholar 

  2. Dooley JM, Goulden KJ, Gatien JG, Gibson EJ, Brown BSJ (1986) Topical therapy for oropharyngeal symptoms of myasthenia gravis. Ann Neurol 19:192–194

    Google Scholar 

  3. Gotti C, Mantegazza R, Clementi F (1984) New antigen for antibody detection in myasthenia gravis. Neurology 34:374–377

    Google Scholar 

  4. Hardy JG, Lee SW, Wilson CG (1985) Intranasal drug delivery by spray and drops. J Pharm Pharmacol 37:294–297

    Google Scholar 

  5. Italian Collaborative Group on MG (ICGMG) (1986) Surveillance of myasthenia gravis through a multicenter survey. Muscle Nerve 9 [Suppl 5S]:154

    Google Scholar 

  6. Mantegazza R, Antozzi C, Peluchetti D, Sghirlanzoni A, Cornelio F (1988) Azathioprine as a single drug or in combination with steroids in the treatment of myasthenia gravis. J Neurol 235:449–453

    Google Scholar 

  7. Sghirlanzoni A, Peluchetti D, Mantegazza R, Fiacchino F, Cornelio F (1984) Myasthenia gravis: prolonged treatment with steroids. Neurology 34:170–174

    Google Scholar 

  8. Taylor P (1985) Anticholinesterase agents. In: Goodman Gilman A, Goodman LS, Rall TW, Murad F (eds) The pharmacological basis of therapeutics, 7th edn. MacMillan, New York, pp 110–129

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sghirlanzoni, A., Pareyson, D., Benvenuti, C. et al. Efficacy of intranasal administration of neostigmine in myasthenic patients. J Neurol 239, 165–169 (1992). https://doi.org/10.1007/BF00833919

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00833919

Key words

Navigation