ABSTRACT
A 37-year-old woman developed thigh tightness and increased tiredness after stair climbing or walking, approximately four weeks after starting nasal beclomethasone inhaler therapy (one to sprays in each nostril twice daily) for seasonal allergic rhinitis. Other medications included carbamazepine (no dosage provided) for seizures. Although a physical examination was normal, a neurologic exam revealed mild to moderate decreased in strength in neck flexion, shoulder abduction and hip flexion. Muscle strength in other areas and deep tendom reflexes were normal. Normal laboratory values also included erythrocyte sedimentation rate, thyroid function tests, and cortisol and serum creatine kinase levels. Carbamazepine serum levels were also within therapeu tic range. Voluntary contraction of proximal muscles suggested steroid induced myopathy. Approximately one month after beclomethasone therapy was stopped, the patient exhibited normal exercise tolerance and strength. Symp toms did not recur within a two-year follow-up.
