Myasthenia-like syndrome induced by overdosage of cibenzoline.
A case of cibenzoline-induced myasthenia-like syndrome is reported. A 67-year-old woman with renal failure and no previous disorder of neuromuscular junction complained of fatigue during climbing up a flight of stairs and experiencing heavy eyelids after administration of 100 mg/day of cibenzoline. Repetitive nerve stimulation tests revealed decrement at 5-10 Hz. After reduction of the dosage, myasthenia-like signs and symptoms disappeared. The peak cibenzoline concentration was still high even after the dose reduction (666.4 ng/ml). In conclusion, cibenzoline, at a high plasma level, may induce myasthenia-like syndrome without any disorder of the neuromuscular junction.
Kasuga
A
A
Department of Internal Medicine, Keio University School of Medicine, Tokyo.
Maruyama
H
H
Sato
T
T
Nogawa
S
S
Mitamura
H
H
Saruta
T
T
D000368:Aged; D000784:Aortic Dissection / Q000150:complications; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001014:Aortic Aneurysm / Q000150:complications; D001281:Atrial Fibrillation / Q000150:complications / Q000188:drug therapy; D001763:Blepharoptosis / Q000139:chemically induced*; D048909:Diabetes Complications; D005221:Fatigue / Q000139:chemically induced*; D005260:Female; D006111:Graves Disease / Q000150:complications; D006801:Humans; D006973:Hypertension / Q000150:complications; D007093:Imidazoles / Q000008:administration & dosage / Q000009:adverse effects*; D007676:Kidney Failure, Chronic / Q000150:complications; D009157:Myasthenia Gravis
D000889:Anti-Arrhythmia Agents; D007093:Imidazoles; C032151:cifenline