Efficacy of intranasal administration of neostigmine in myasthenic patients

Angelo Sghirlanzoni, Davide Pareyson, Claudio Benvenuti, Giovanni Cei, Vittorio Cosi, Mariella Lombardi, Mariaflavia Nicora, Roberta Ricciardi, Ferdinando Cornelio

Research output: Contribution to journalArticlepeer-review


The efficacy of intranasally administered neostigmine was tested in 22 patients with generalized myasthenia gravis (MG). Topical therapy to the highly vascularized oropharynx proved to be quickly effective in 5-15 min both clinically and electrophysiologically. Twenty-eight MG patients were then recruited from different centres and their morning doses of oral pyridostigmine were substituted with intranasal neostigmine over a period of 2 or 3 weeks. Intranasal neostigmine proved to be equally efficacious in this regimen. No side-effect was noted even in 4 patients treated in this way for 1 year. Intranasal administration of anti-acetylcholinesterase may be very beneficial: (1) for patients with irregular absorption of oral doses; (2) early in the morning and every time a fast and temporary effect is needed; (3) in bulbar impairment and emergencies, in which a handy atomizer may be life-saving.

Original languageEnglish
Pages (from-to)165-169
Number of pages5
JournalJournal of Neurology
Issue number3
Publication statusPublished - Mar 1992


  • Autoimmunity
  • Cholinesterase inhibitors
  • Intranasal administration
  • Myasthenia gravis
  • Neostigmine

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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