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Verification by Edrophonium Tonography

James R. Keane, MD; William F. Hoyt, MD

JAMA. 1970;212(7):1209-1210.

Abstract
An unusual delayed-onset myasthenic nystagmus appearing during sustained upward gaze suggested the presence of brain-stem disease in a 35-year-old construction worker who was being evaluated for his complaints of progressive instability of gait. The etiology of the nystagmus and the systemic symptoms was established objectively by an edrophonium chloride (Tensilon) tonogram test; this is a sensitive means of recording edrophonium-induced increase in extraocular muscle tone as indicated by a rise in the Schiotz tonogram.

Author Affiliations
From the Neuro-Ophthalmology Service of the departments of ophthalmology, neurology, and neurological surgery, University of California Medical Center, San Francisco. Dr. Keane was a Special Fellow in Neuro-Ophthalmology, supported by Public Health Service research fellowship 7 F11 NB 1859-02 NSRB. Dr. Keane is now with Los Angeles County/USC Medical Center, Los Angeles.

Footnotes
Reprint requests to 1200 N State St, Los Angeles 90033 (Dr. Keane).

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