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Myasthenia Gravis

Mestinon

04/04/2008

Question:

Dr. Neel, in one of your responses you mentioned that a positive response to Mestinon may not always mean Myasthenia.  What other disease process would someone have a positive or improvement with from taking Mestinon? I am not quoting your response, but that is what basically I am taking it from. Thanks.

Answer:

Mestinon can have a positive clinical effect, like in myasthenics, with nerve related muscle damage. For example, it has been reported to have positive symptomatic benefit in some patients with amyotrophic lateral sclerosis (Lou Gehrig's disease), poliomyelitis (polio), and even in neuropathies and some radiculopathies (damage to nerve roots in the back or neck). It is thought to be effective because the damaged tissues create less acetylcholine at the sites of re-innervation, and the mestinon allows the acetylcholine that is created to hang around longer at those damaged sites. Another rare condition that can have a response to mestinon is Lambert Eaton Myasthenic syndrome.

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Response by:

Robert W Neel, IV, MD Robert W Neel, IV, MD
Assistant Professor of Neurology
College of Medicine
University of Cincinnati