A 13-year-old boy with variable weakness became transiently stronger in proximal muscles with repetitive strength testing and then showed progressive fatigability. Repetitive electrical stimulation studies were most compatible with myasthenia gravis, but incremental responses resembled those in the myasthenic syndrome occasionally associated with bronchial neoplasm. Both guanidine and neostigmine produced excellent clinical control of the fatigability.
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Dahl et al. (1974) studied this question.
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