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A 70-year-old man with myasthenia gravis received a single intramuscular injection of colistimethate sodium (150 mg) for a urinary tract infection. He developed a respiratory arrest with a complete flaccid paralysis three hours later. All muscles but those associated with respiration improved rapidly following intramuscular neostigmine methylsulfate (2 mg) and intravenous edrophonium chloride (10 mg) administration. A combination of ventilation support and anticholinesterase therapy brought about recovery in 11 days. Carbenicillin effectively eradicated the Pseudomonas infection without causing neuromuscular impairment.

ALTHOUGH cases of agnosia for sound and music have been reported for more than 80 years,1-10 such defects were invariably observed to be associated with at least a mild impairment in language recognition, ie, auditory verbal agnosia. According to Nielsen,11 only one case of an agnosia for sounds without evidence of aphasia either in the history or in the present clinical picture has so far been on record. This patient was a 52-year-old Mexican man who was examined with the aid of an interpreter.12 An older vascular lesion had caused a left hemiparesis in this patient, and a more recent lesion resulted in a total loss of light perception, disorientation in space, loss of ability to visualize, incapacity to form nonlanguage concepts through sensory impressions, and unawareness of the left side of the body. The patient denied the loss of vision and in doing so would, eg,