The edrophonium test helps diagnose myasthenia gravis. It also helps to decide on essentially the most appropriate treatment dose and follow-up. In this text we’ll explain how it really works!
The edrophonium test, also called the Tensilon® test, is a pharmacological test. It consists in injecting edrophonium bromide or edrophonium chloride, that are substances that react with the transmission of nerve impulses on the muscular level.
The goal is to check the patient’s muscle fatigue. Therefore, doctors prescribe it to diagnose and assess response to treatment myasthenia gravis.
This test is taken into account effective and is essentially the most commonly used test for this disease. However, it should be done with a couple of precautions. In this text, we’ll explain what the edrophonium test is and the way it really works.
What is an edrophonium test?
The edrophonium test, along with being called the Tensilon® test, can be called the Anticude® test. These names are different because they seek advice from the brand of the drug.
Tensilon® is edrophonium chloride, while Anticude® is edrophonium bromide, as explained within the Agència Valenciana de Salut publication. These drugs work on the neuromuscular level and forestall the breakdown of acetylcholine, which is a neurotransmitter that works within the neuromuscular junction.
That is, in the world where neurons bind to muscle fibers to stimulate them. By inhibiting the breakdown of acetylcholine, there may be a more pronounced muscle stimulation.
Therefore, the edrophonium test is predicated on observing what response occurs on the muscular level. There are diseases similar to myasthenia gravis, through which there are changes in muscle fibers under the influence of acetylcholine. Therefore, it is helpful in diagnosing and monitoring this disease.
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When is edrophonium testing mandatory?
Doctors normally order an edrophonium test when they believe a patient has it myasthenia gravis. They also use it to manage doses of anticholinesterase drugs once the disease has been diagnosed and patients taking these drugs as a part of treatment.
As explained within the previous section, the neuromuscular junction is where nerves and muscle fibers communicate. In this area, the nerve secretes a neurotransmitter called acetylcholine, which binds to muscle receptors.
IN myasthenia gravis, the immune system produces antibodies that block or destroy the acetylcholine receptors. As a result, the muscle receives less stimulation. As a result, there may be weakness and rapid muscle fatigue.
IN myasthenia gravisweakness worsens with use of the affected muscle. According to Mayo Clinic specialistssymptoms subside with rest.
As the years go by, symptoms progress and rest periods not compensate for weakness. More than half of patients begin with symptoms in the attention muscles. Therefore, two quite common symptoms are ptosis and double vision.
What is edrophonium used for myasthenia gravis?
The edrophonium test doesn’t break down acetylcholine. An enzyme called acetylcholinesterase is answerable for this breakdown. Since it shouldn’t be broken up, there may be more concentration. Therefore, muscle stimulation is bigger.
When a patient with myasthenia gravis passes the edrophonium test, the muscles are stronger. In addition, this test also makes it possible to judge essentially the most appropriate treatment by way of dosage.
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Previous preparation
Before taking an edrophonium test, it will be significant to think about certain points. The doctor must know what medications the patient is taking, including supplements or other herbal remedies.
The reason is that a lot of these substances can interfere with the result. For example, those that almost all commonly alter the edrophonium test are acetylcholinesterase inhibitors. These are medicines used to treat dementia, similar to donepezil and rivastigmine.
The idea is that the doctor will advise whether the patient should stop using them before undergoing the test. It can be possible that your doctor may impose some dietary restrictions in the times leading as much as your test.
How is the edrophonium test performed?
The edrophonium test is performed by a physician and is often done in a specialist neurology office. First, the specialist places an intravenous needle within the patient’s arm or hand.
They then inject a small amount of edrophonium through a needle. To begin testing for myasthenia gravis, the doctor asks the person to make repetitive movements.
As an article about Servizo Galego de Saude explains, movements can involve different parts of the body. For example, getting up from a chair, crossing and spreading your legs, and keeping your arms raised. The test also tests the voice by asking the patient to count backwards from 100.
During the edrophonium test, several doses of the drug are injected. This checks whether the muscle is recovering from each injection. If so, the doctor will make a diagnosis myasthenia gravis.
What does the result mean?
The edrophonium test results are often immediate. As we explained within the previous section, the patient is given a diagnosis myasthenia gravis if the muscle regains some strength after each injection of edrophonium.
However, in some cases, other tests are mandatory to verify the diagnosis. In this case, if edrophonium causes a transient stimulation, it implies that the disease has worsened. On the opposite hand, if the injection of the drug weakens the muscle, the test indicates an anticholinesterase overdose.
Risks and proposals
Experts consider that the edrophonium test is effective and protected. However, there are a couple of unintended effects that occur steadily. However, they’re short and typically don’t last greater than a couple of minutes.
Nausea and abdominal pain are two of essentially the most common effects. Shortness of breath, sweating, dizziness, and blurred vision might also occur. Other patients experience twitching of the eyelids, increased salivation, and even fainting.
As with any injection, a bruise may appear on the injection site. Ideally, the patient should apply compression or ice in the primary 24 hours to scale back swelling.
There are a couple of cases where the edrophonium test has serious repercussions. Therefore, experts don’t recommend it to individuals with underlying arrhythmias, low heart rate or hypotension.
The same applies to patients with sleep apnea and asthma. While there are indeed limited unintended effects, in cases where discomfort persists, a specialist may administer an injection of atropine to reverse the results.
The predominant reason for this test is Myasthenia gravis
The edrophonium test is a useful test for diagnosis myasthenia gravis. It can be useful for monitoring the treatment of this condition.
Drug dosing problems are common. It is significant to usually examine these patients to avoid serious complications. In addition, experts consider this test to be protected and effective so long as it is completed in a controlled environment.
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