What is a cholinergic crisis?
Overdosing with anticholinesterase may result in excessive ACh in the synaptic cleft, causing a depolarizing block of AChRs.
The end result is defective neuromuscular transmission causing symptoms similar to those of a myasthenic crisis.
Fasciculations are also common. Establishing an airway, supporting respiration, and withholding anticholinesterase medications are the mainstays of treatment.
This complication is rarely seen today because lower doses of anticholinesterase are typically utilized due to successful primary immunomodulatory therapy.
