What experience do you have with paralysis or myasthenia-like symptoms developing on temozolomide?

This is not an established toxicity of temozolomide and would warrant further investigation.

I have not had a patient with this adverse effect. Mechanistically, I am not sure how this would be explained by the drug. I would recommend a workup for other contributing factors. I was unable to find any reports in the literature of TMZ-induced MG.