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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Myasthenia gravis, drooping eyelid, done EMG. Prescribed pyridostigmine bromide

History of illness March-2012- My family members noticed that my left eye became smaller then right eye. But that time I had no problem with vision or eye lid drooping. 14 Jul 2012- I had problem in my left eye; my eye lid started drooping frequently and was painful as well. Hence I visited NMC eye specialist Abu Dhabi U.A.E whereby he prescribed me some eye drop and Amoxilene antibiotic medicine. No improvement was noticed. 17 Jul 2012- Visited eye specialist at Lifeline Hospital Abu Dhabi U.A.E,and looking at all the symptoms he came up to conclusion that may be I might be a Myasthenia Gravis case and referred me to neurologist . 18 Jul 2012- Visited Ahalia Hospital neurology department Abu Dhabi U.A.E. And initial symptoms lead doctor to conclusion that I may be suffering with Myasthenia Gravis but due to lack of proper instruments further tests couldn’t be carried forward and hence I decided to consult doctors and do proper examination and tests in India on 21 July, 2012. 21 Jul 2012- Visited to Ahmedabad most senior Neurologist Dr. Ajit Sowani M.D. (D M Neurology, Mumbai) and after series of tests and diagnosis I was being declared with Myasthenia Gravis. Detail of Test & Result 1- CT Scan of THORAX Result-No evident CT abnormality detected. 2-Blood Test-CBC,ESR, THYRODI FUNCTION TEST,HIV I $ II ,RANDOM BLOOD GLUCOSE, Anti AChr antibody,etc Result- found OK. 3- EMG Result--Right and left Orbicularis Oculi show evidence of neuro- muscular (Fatigibility) disease in both Orbicularis Oculi Doctor has prescribed to take medicine - PYRIDOSTIGMINE BROMIDE 60MG Three times a day. Medicine History Date Medicine Name Dose 21-07-12 04-08-12 PYRIDOSTIGMINE-60MG 3TAB- / DAY (1+1+1) 05-08-12 11-08-12 PYRIDOSTIGMINE-60MG 4TAB- / DAY (1+1+1+1) 12-08-12 17-08-12 PYRIDOSTIGMINE-60MG 4TAB- / DAY (1+1+1+1) PREDNISOLONE-10MG 2TAB- / DAY ( 1+0+1) 18-08-12 13-09-12 PYRIDOSTIGMINE-60MG 2TAB- / DAY (1+1) PREDNISOLONE-20MG 2TAB/ 3DAYS WEEKLY (2+0+0) RANITIDINE-150MB 1TAB- / DAY (1+0+0) B COMPLEX,VITAMIN C TAB 1TAB- / DAY (1+0+0) 14-09-12 PYRIDOSTIGMINE-60MG 4TAB- / DAY (1+1+1+1) PREDNISOLONE-20MG 3TAB/ 3DAYS WEEKLY (3+0+0) RANITIDINE-150MB 1TAB- / DAY (1+0+0) B COMPLEX,VITAMIN C TAB 1TAB- / DAY (1+0+0)
Tue, 6 Aug 2013
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Ophthalmologist 's  Response
Hi..
According to the details given by you, you are taking right treatment.
Because it is evident that the orbicularis muscle is fatiguable you are getting drooping after some time because of the depletion of neurotransmitter material there.
You have to continue the treatment for a long time.
There can be remissions and exacerbations.
Don't worry.. Keep following up at specified intervals.
Take care. Will be available for further queries..
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