Safety of edrophonium chloride (Tensilon) test as a diagnostic tool in Myasthenia gravis

Objective: To evaluate the safety of edrophonium chloride in the course of the Tensilon test by measurement of hemodynamic and ECG parameters and the observation of adverse events. Methods: 25 patients with known or suspected myasthenia gravis were include d in an open, prospective study concerning the performance of the Tensilon test. Blood pressure, heart rate, continuous ECG and adverse events were re corded 10 minutes following intravenous application of Tensilon. Results: Blood pressure and heart rate did not change significantly during the observation period. One patient on beta-blockers developed a grade I AV block. Self-limiting adverse events of short duration were observed in 11. patients. Serious adverse events such as syncope or hemodynamic deteriorat ion did not occur. Conclusion: The Tensilon test appears to be a safe procedure. A detailed cl inical cardiac history, the history of medication and twelve lead ECG recor dings should be documented in all patients undergoing the Tensilon test. Pa tients with a history of dysrhythmia receiving digitalis, beta-blocking age nts or Ca antagonist therapy should be managed with special care, as Tensil on enhances vagal effects.