Exam

Tensilon Test

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Tensilon Test, Edrophonium Test

  • Indications
  1. Ptosis evaluation in suspected Myasthenia Gravis
  • Contraindications
  • Adverse Effects
  1. Increased Salivation
  2. Abdominal cramping
  3. Bradycardia
  4. Syncope
  5. Bronchospasm
  • Mechanism
  1. Edrophonium (Tensilon) is a rapid onset, short acting Acetylcholinesterase Inhibitor
  • Preparation
  1. Perform with telemetry monitoring
  2. Atropine 0.5 mg IV prn symptomatic Bradycardia
  • Technique
  1. Edrophonium (10 mg/ml) 1 ml is drawn into a 1 cc syringe (tuberculin syringe)
  2. Inject edrophonium 2 mg (0.2 cc) IV every minute up to cummulative dose of 10 mg
  3. Stop when improvement in Ptosis is observed or 10 mg is reached (typically at 4-6 mg or 0.4 to 0.6 cc)
  • Interpretation
  1. Ptosis improvement with edrophonium is suggestive of Myasthenia Gravis
  • Efficacy
  1. Test Sensitivity: 80-90%
  2. False Positives
    1. Motor Neuron disorders
    2. Brainstem tumor
    3. Compressive cranial Neuropathy