Te the Editor: Although our experience with gradually increasing doses of prednisone in myasthenia gravis is limited, it differs sufficiently from that of Seybold and Drachman (N Engl J Med 290:81–84, 1974) to warrant comment. Three patients have been treated since June, 1973, with the regimen that they outline. All had moderately severe generalized weakness, including bulbar involvement. All experienced fluctuations in strength from the outset of therapy, with weakness on the days off prednisone. Fluctuations preceded by a week or more any perceptible trend toward improvement, and was such as to make swallowing marginal on the “off” day. In ….
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