top of page
neurologia curitiba

myasthenia gravis

Amyasthenia gravisit is an autoimmune disease, in which the individual's own antibodies "attack" the acetylcholine receptors present in the muscles. With this action, the person tends to feelmuscle weakness, which can be located more in the eyes (eye shape) or in the whole body (systemic form).

Very commonly theonset of illnessit is noticed with a droopy eye, double vision or onset of fatigue and marked tiredness.

Diagnosis of Myasthenia

OdiagnosisMyasthenia is usually carried out through a medical evaluation with a neurologist, associated with the performance of some tests, among which the main ones are:


This is an exam in which small shocks are made to evaluate the conduction of the nerve to the muscle. Ideally, TER (Repetitive Stimulation Test) should be performed using a single fiber.

Anti-Acetylcholine Receptor Antibodies

Examination performed through simple blood collection.

neurologista especialista em miastenia
Medicines that should
be avoided in myasthenia

Some medications that should be avoided in patients with Myasthenia Gravis, due to the risk of worsening the symptoms of the disease. The main drugs to avoid are these:

  • Antibiotics:

    • at risk: aminoglycosides, tetracillin, lincomycin, clindamycin, bacitracin, polymyxins.

    • Doubtful: ampicillin, erythromycin, sulphamide.

    • no risk: penicillin, chloramphenicol, cancomycin, cephalosporins.

  • Anticholinergics (amitriptyline, baclofen)

  • Antihistamines (allergy medications)

  • Major muscle relaxants: pancuronium, succinylcholine, d-turbocurarine.

  • Minor muscle relaxants: benzodiazepines, baclofen, dantrolene, meprobamate.

  • Cardiovascular: procainamide, quinidine, lidocaine (mainly systemic route), guanethidine, trimetaphan, beta blockers, reserpine, magnesium sulfate,_cc781905-5cde-3b5cf58d_6b5dagonists of calcium.

  • Anticonvulsants: hydantoins, benzodiazepines, barbiturates, ethosuximide.

  • Psychotropics: benziodiazepines, tricyclic antidepressants, lithium carbonate, MAO inhibitors, neuroleptics (phenothiazines and butyrophenones).

  • Analgesics: morphine, dipyrone

  • Laxatives and enemas: decrease the absorption of anticholinesterases and deplete potassium. Some have magnesium in their composition.

  • Immunizations: Some vaccines and tetanus serum

  • Others: amantadine,  magnesium-containing antacids, quinolones - levofloxacin (several patients reported marked iodine weakness).

The ideal is to keep this medication list with you at all times. In the event of an emergency, this list can be very important.

Myasthenia treatment
OtreatmentMyasthenia is done using specific medications that aim to reduce the action of antibodies, such asCorticosteroids(prednisone), cholinesterase inhibitor drugs such asMestinon(pyridostigmine), in addition toimmunosuppressants, such as azathiopyrine, cyclophosphamide, cyclosporine.
As there are different stages and types of the disease, the treatment has to be veryindividualized, with proper follow-up by a neurologist.
bottom of page