A 23-year-old man complains of intermittent double vision and fatigue. The symptoms are worse at the end of the day, and he has stopped working as a courier because of easy leg fatigue and weakness. He finds that the symptoms improve with resting. On physical examination, there is weakness of the eyelids, masticatory muscles, and thigh flexors. Having him look up at the ceiling for a long time brings on his double vision. There is no sensory abnormality, and reflexes are normal. Which of the following treatments is contraindicated in this patient?
Anticholinergic drugs exacerbate the underlying defects in patients with myasthenia gravis. Cholinergic drugs are largely inhibitors of cholinesterase. Prednisone may improve as many as 80% of patients. Thymectomy helps patients with no thymoma, but thymoma patients do not do as well. Plasmapheresis benefits most patients but needs to be repeated at intervals.
anticholinergic drugs
surgery
plasmapheresis
cyclophosphamide
C.N.S.