No abstract available.
Lambert-Eaton Myasthenic Syndrome*

Myasthenia gravis (MG) differs from the Lambert-Eaton syndrome (LES) clinically, electrophysiologically, and therapeutically. However. There had been a few reports documenting the coexistence of MG and LES in the same patient, which is termed as "overlap myasthenic syndrome". We had studied a patient who had showed all the clinical characteristics of MG including positive response to pyridostigmin. Unlike the usual response in MG, there had been an abnormal incremental responses at post-exercise and high rate stimulation with abnormal decremental responses at low-rate stimulation in repetitive nerve stimulation test, which satisfies the diagnostic criteria of both MG as LES.
Humans ; Lambert-Eaton Myasthenic Syndrome ; Myasthenia Gravis

No abstract available.
Immunization, Passive ; Immunoglobulins ; Lambert-Eaton Myasthenic Syndrome

No abstract available.
Drug Therapy* ; Lambert-Eaton Myasthenic Syndrome* ; Small Cell Lung Carcinoma*

The Lambert-Eaton myasthenic syndrome (LEMS) heralds the occurrence of malignancy, especially small-cell lung cancer (SCLC), but it can also occur in the absence of cancer. Twelve patients were diagnosed as LEMS by clinical features and the classical electrophysiological triad, which includes a low amplitude of compound muscle action potentials (CMAP), decremental responses on low-rate stimulation, and incremental responses on high-rate stimulation on the repetitive nerve stimulation (RNS) test. There were 6 male and 6 female patients, ranging in age from 49 to 66 years. Malignancy(all were SCLC) was found in 7 patients. Males predominantly expressed the paraneoplastic form; whereas the primary autoimmune form was found only in women, who showed a good response to corticosteroid treatment. The neurological features were similar in both groups: proximal lower limb weakness, depressed muscle stretch reflexes, and dryness of mouth in nearly all patients. Bulbar dysfunction and limb paresthesia were a little more frequent in the paraneoplastic form. In RNS tests, the characteristic electrophysiological abnormalities were found in all patients and were more profound in the paraneoplastic form. We concluded that LEMS is commonly associated with malignancy, especially SCLC, but it should also be stressed that there are many female LEMS patients who do not harbor any malignancy at all, and that other treatment strategies such as immunotherapy should be considered for these patients.
Aged ; Carcinoma, Small Cell/complications ; Female ; Human ; Lambert-Eaton Myasthenic Syndrome/therapy ; Lambert-Eaton Myasthenic Syndrome/physiopathology* ; Lung Neoplasms/complications ; Male ; Middle Age ; Paraneoplastic Syndromes/physiopathology

In one case of cancer-associated Lambert-Eaton myasthenic syndrome (LEMS), treatment with cytotoxic chemotherapy and radiotherapy resulted in remission of both cancer and neuromuscular disorder. Serial repetitive nerve stimulation (RNS) findings showed that the typical RNS features of LEMS returned to normal in the orders of dramatic postexercise facilitation, an incremental response in high rate stimulation, and a decremental response in low rate stimulation with clinical improvement.
Drug Therapy* ; Lambert-Eaton Myasthenic Syndrome* ; Radiotherapy* ; Small Cell Lung Carcinoma*

BACKGROUND: The coexistence of myasthenia gravis (MG) and Lambert-Eaton myasthenic syndrome (LEMS) is very rare and remains controversial. CASE REPORT: A 48-year-old woman initially presented with noticeable right ptosis and intermittent diplopia. She then developed fluctuating proximal limb weakness and difficulty in swallowing. The serum titer of anti-acetylcholine-receptor antibody was elevated and the edrophonium (Tensilon) test was positive. However, repetitive nerve stimulation revealed abnormalities typical of LEMS. The patient exhibited a good response to treatment with anticholinesterase inhibitors and steroids, and long-term evaluation disclosed that she presented with the clinical, electrophysiological, and immunological characteristics of both diseases. CONCLUSIONS: The reported clinical and electrophysiological features suggest that this patient was a very rare case of combined MG and LEMS.
Deglutition ; Diplopia ; Edrophonium ; Extremities ; Female ; Humans ; Lambert-Eaton Myasthenic Syndrome ; Middle Aged ; Myasthenia Gravis ; Steroids

There are many causes of prolonged postoperative muscle weakness, including drugs, residual anesthetics, cerebrovascular events, electrolyte imbalance, hypothermia, and neuromuscular disease. Neuromuscular diseases are relatively rare, with the most common being myasthenia gravis and Lambert-Eaton myasthenic syndrome (LEMS). We report an unusual case in which a patient who was given a muscle relaxant during mediastinoscopy developed postoperative muscle weakness that was ultimately diagnosed as secondary to LEMS.
Anesthetics ; Humans ; Hypothermia ; Lambert-Eaton Myasthenic Syndrome ; Mediastinoscopy ; Muscle Weakness ; Muscles ; Myasthenia Gravis ; Neuromuscular Diseases

Lambert-Eaton myasthenic syndrome (LEMS) is characterized clinically by fluctuating muscular weakness; presentation with ocular symptoms is unusual. A 60-year-old man had developed diplopia and ptosis 2 years previously. The findings of a neurologic examination were normal except for bilateral ptosis and ophthalmoplegia. The amplitude of compound muscle action potentials recorded on the abductor digiti minimi increased (by more than 500%) during 50-Hz stimulation. This case demonstrates that LEMS should be included in the differential diagnosis of myasthenic symptom confined to the ocular muscles.
Action Potentials ; Diagnosis, Differential ; Diplopia ; Humans ; Lambert-Eaton Myasthenic Syndrome ; Middle Aged ; Muscles ; Neurologic Examination ; Ophthalmoplegia

The Lambert-Eaton myasthenic syndrome (LEMS) is typically recognized as a paraneoplastic syndrome associated with a small cell lung carcinoma (SCLC), whereas LEMS with other neuroendocrine lung tumors, including carcinoids or large cell lung carcinoma, are highly unusual. Here, we report a rare case of LEMS with atypical bronchopulmonary carcinoid tumor: A 65-yr-old man presented with progressive leg weakness and a diagnosis of LEMS was made by serial repetitive nerve stimulation test. Chest CT revealed a lung nodule with enlargement of paratracheal lymph nodes, and surgically resected lesion showed pathological features of atypical carcinoid tumor. We concluded that LEMS could be associated with rare pulmonary neuroendocrine tumor other than SCLC, which necessitates pathologic confirmation followed by aggressive treatment for optimal management in these rare cases.
Aged ; Carcinoid Tumor/*complications/pathology/surgery ; Electromyography ; Humans ; Lambert-Eaton Myasthenic Syndrome/*complications/diagnosis ; Lung Neoplasms/*complications/pathology/surgery ; Male