TABLE 44-1
Characteristics of Myasthenic and Cholinergic Crises
MYASTHENIC CRISIS
Increased pulse and
respiration
Rise in blood pressure
Bowel and bladder
incontinence
Decreased urine output
Absence of cough and
swallow reflex
Improvement of
symptoms with
edrophonium test*
FEATURES
CHOLINERGIC CRISIS
COMMON TO
BOTH
Bradycardia and
bronchospasm (lifethreatening
symptoms!)
Flaccid paralysis
Hypersecretion:
salivation, tearing, and
sweating
Nausea/vomiting
Diarrhea
Abdominal cramps
Miosis, blurred vision
Worsening of symptoms
with edrophonium test
Apprehension
Restlessness
Dyspnea
Dysphagia
(difficult
swallowing)
Generalized
weakness
Respiratory
failure
Edrophonium (Enlon, Tensilon) is given IV; muscle movement improves immediately
in patients with myasthenia or myasthenia crisis.
*