Tanzania						                            
                            
						
 Case Report
												Pyridostigmine-Induced High Grade SA-Block in a Patient with Myasthenia Gravis 						
Author(s): Sarmad  Said, Haider  Alkhateeb, Chad  Cooper, Sherif  Elhanafi, Sayeed  Khalillullah, Sucheta  Gosavi and Zainul  AbedinSarmad  Said, Haider  Alkhateeb, Chad  Cooper, Sherif  Elhanafi, Sayeed  Khalillullah, Sucheta  Gosavi and Zainul  Abedin             
						
												
				 Myasthenia gravis requires a long-term treatment with a parasympathomimetic agent, which may result in bradycardia and asystole. Pharmacologic treatment with a reversible inhibitor of Inosine Monophosphate Dehydrogenase (IMPDH) and Methylprednisolone are seen to improve the muscular symptoms but may reinforce potential bradyarrhythmias. This potential side effect can be treated with the levo isomer of atropine, Hyoscyamine, or Glycopyrollate in an intact conduction system. Case presentation:A 70-year old Caucasian female patient with a family history of myasthenia gravis presented with mild weakness of the bilateral facial muscles, moderate dysarthria, dysphagia, diplopia predominantly on the right side and difficulty tracking ocular movements bilaterally. The treatment with pharmacological agents was initiated. Subsequently she developed asymptomatic bradycardia and SA-block. An impr.. Read More»
				  
												DOI:
												 10.4172/2165-7920.1000290 
																	  
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