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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Myasthenia Gravis ocular. Taking Prednisone 10mg. Swelling not come down. Suggestion?

I have Myasthenia Gravis, Ocular. Diagnosed in February of this year. I started with 100mg of Prednisone. Now down to 25mg for the past 2 weeks. My neurologist said my moon face and balloon neck will decrease as the steroids decreased. Nope, not yet. I am seeing my neurologist this coming Friday and I am going to ask her if I can take a jump from 25mg down to 10mg. Question 1: I did the decrease in 5mg increments. Will the 15mg jump I am going to suggest be too much? Question 2: If at 10mg, will I see a change in the moon face and balloon neck? I really hate to be seen in public as I am. Question #3: Is it true a banana a day will stop the leg & feet cramps and also 200mg of Vitamin B-6 will help with the moon face and balloon neck and could possibly get rid of it?
Thu, 18 Jul 2013
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General & Family Physician 's  Response
Thanks for the query to H.C.M. Forum.
Moon face & balloon neck is due to retention of fluid due to side effect of prednisolone.
Query no.
1 Dose of prednisolone will be decided by your treating doctor as he know better about the condition.
2 10 mg also causes fluid retention so until diuretics not given , it is very hard to get rid of this moon face. Consult your doctor about diuretics.
3 Banana contains potassium , so definitely it will relief in cramps.
B 6 have no direct effect over moon face.
Good luck.
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General & Family Physician Dr. Jose Ignacio Artero Munoz's  Response
Hello.Corticosteroids by mouth as Prednisone are the mainstay of treatment of myasthenia even causing adverse effects such as moon face.
Dose decrease that you say (15 mg) is excessive because symptoms of myasthenia may worsen and because the decrease in the dose of corticosteroids should be very gradually.Your neurologist will say you the right rhythm in the decrease of the dose of corticosteroid. A lower dose will decrease side effects such as moon face.
About vitamin B6, there is not enough scientific evidence to recommend its use in this situation.About the intake of a banana per day, may be favorable to balance blood potassium levels (normally descended in people taking corticosteroids) but you need to do before one analytical to know the blood potassium level.
I wish you good health.
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