The preventive effect of Atrovent® Dosier-Aerosol on the airway flow resistance (R_aw) caused by Tensilon® was studied on 10 patients suffering from myasthenia gravis. Atrovent completely prevented the increase of R_aw in 8 cases and considerably decreased it in 2 cases. The measure of the reaction observed may be influenced by the intensity of the cholinergic symptoms occurring on administration of Tensilon as well as by the magnitude of the initial R_aw value. No side-effect which may be attributed to the administration of Atrovent could be observed, the substance did not increase the myasthenic symptoms. According to the study, Atrovent is a suitable medicine for the prevention of airway obstruction caused by Tensilon.

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25 myasthenia gravis-afflicted patients (14 crisis-endangered and 11 not endangered) were investigated with respect to their respiratory function and reaction of the respiratory parameters to Tensilon® (edrophonium chloride). Results show that the vital capacity and the value of respiratory function parameters, measured under forced conditions, were partly significantly lower than those given as predicted values for healthy individuals. Maximal inspiratory flows indicated the greatest decrease. After intravenously administered Tensilon®, the pathologically reduced maximal inspiratory flows increased. This positive effect of Tensilon® can mark the alteration of the respiratory muscles and also the undertreatment of the patients. The observation that Tensilon® may increase – with some permanency – the respiratory flow resistance and may decrease the maximal expiratory flow values, draws attention to the side effect (causing obstruction of the bronchi) of the drug, limiting its therapeutic use for patients in myasthenic crisis, especially in those complicated by obstructive lung disease.

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The authors review the theoretical basis of human antilymphocyte globulin (ALG) and human antithymocyte globulin (ATG) treatment in myasthenia gravis. Ten selected seriously ill myasthenic patients were treated with ALG and/or ATG. Three of the patients improved significantly and a further four moderately, whereas the condition of three patients did not change. ALG therapy is effective in the suppression of cellular immune mechanism, therefore it can be assumed that it exerts its effect in myasthenia gravis by inhibiting thymus hormone stimulation.