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Pediatric Rounds Review Questions
Dysphagia, Hoarseness, and Weakness
in a 12-Year-Old Girl

Answer 2

  1. Edrophonium chloride challenge. Edrophonium chloride (Tensilon) should be given when a known myasthenia gravis patient presents with worsening weakness. A positive response (improved muscle strength) suggests a myasthenic crisis, which should be treated appropriately with intravenous immunoglobulin or plasmapheresis. A negative response (muscle fasciculations or respiratory depression) indicates cholinergic overdose.

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