Journal of Neurology

, Volume 239, Issue 3, pp 165–169 | Cite as

Efficacy of intranasal administration of neostigmine in myasthenic patients

  • Angelo Sghirlanzoni
  • Davide Pareyson
  • Claudio Benvenuti
  • Giovanni Cei
  • Vittorio Cosi
  • Mariella Lombardi
  • Mariaflavia Nicora
  • Roberta Ricciardi
  • Ferdinando Cornelio
Original Communications

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.

Key words

Autoimmunity Cholinesterase inhibitors Myasthenia gravis Neostigmine Intranasal administration 

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Copyright information

© Springer-Verlag 1992

Authors and Affiliations

  • Angelo Sghirlanzoni
    • 1
  • Davide Pareyson
    • 1
  • Claudio Benvenuti
    • 3
  • Giovanni Cei
    • 4
  • Vittorio Cosi
    • 2
  • Mariella Lombardi
    • 2
  • Mariaflavia Nicora
    • 3
  • Roberta Ricciardi
    • 4
  • Ferdinando Cornelio
    • 1
  1. 1.Istituto Neurologico “C. Besta”MilanItaly
  2. 2.Department of NeurologyPavia UniversityPaviaItaly
  3. 3.Formenti SpAMilanItaly
  4. 4.Department of NeurologyPisa UniversityPisaItaly

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