Tensilon test

Pharmacological test used to diagnose myasthenia gravis

A tensilon test, also called an edrophonium test, is a pharmacological test used for the diagnosis of certain neural diseases, especially myasthenia gravis. It is also used to distinguish a myasthenic crisis from a cholinergic crisis in individuals undergoing treatment for myasthenia gravis. The test has fallen out of use due to suboptimal sensitivity and specificity as well as associated adverse risks. Edrophonium is no longer available in the United States and many other countries as of 2018. In newborns, a 0.15 mg/kg dose of neostigmine administered subcutaneously produces a response within ten minutes. In infants, the drug is administered intravenously at a dose of 0.2 mg/kg. Improvement of diplopia is often used as an evaluation item because in this case, placebo effect can be excluded.

The tensilon test is administered by a trained clinician, usually a neurologist. A thorough history taking and physical assessment is done before the administration of test, to rule out hypersensitivity, pregnancy, lactation, and intestinal obstruction. Care is taken while performing the test in individuals over 50, and those under corticosteroids or pro cholinergic drugs. Vital signs are monitored before, during, and after the test. The test should only be performed in a medical center equipped to manage cholinergic crisis. Following the test, the patient is observed for cholinergic responses such as increased salivation, lacrimation, nausea, and vomiting.