lambert-eaton myasthenic syndrome in a patient with small-cell lung cancer: a case report

Coexistence of myasthenia gravis and Lambert-Eaton myasthenic syndrome in a small cell lung cancer patient: A case report Abstract Rationale: Myasthenia gravis (MG) and Lambert-Eaton myasthenic syndrome (LEMS) are both neuromuscular junction diseases, and some controversy exists whether the 2 diseases occur at the same time.

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What is Lambert Eaton myasthenic syndrome?

Lambert-Eaton myasthenic syndrome (LEMS) is a neuromuscular junction disorder characterized by fluctuating proximal limb muscle weakness, decreased deep tendon reflexes and various autonomic symptoms. LEMS is reportedly the most common neurological paraneoplastic syndrome.

What percentage of patients with Lambert-Eaton myasthenic syndrome have an underlying tumor?

Sixty percent of patients with Lambert-Eaton myasthenic syndrome have an underlying tumor. Paraneoplastic Lambert-Eaton myasthenic syndrome is typically associated with small cell lung cancer (SCLC).

Can small-cell lung cancer (SCLC) cause LEMS?

This is the case report of a patient with small-cell lung cancer (SCLC) who developed LEMS. A 68-year-old male patient presented with a 6-month history of progressive weakness of the proximal limbs and a 2-month history of xerostomia.

How common is autonomic dysfunction in Lennox-Gastaut syndrome?

Lancet Neurol 2011;10(12):1099; Reprinted with permission from Elsevier (The Lancet).) Autonomic dysfunction is reported in 80% to 96% of patients with LEMS.14,22,28,29Severe autonomic dysfunction is found on testing even when symptoms are minimal. Both the sympathetic and parasympathetic systems are affected.30,31

How does lung cancer cause Lambert-Eaton syndrome?

If the nerve endings are damaged, the amount of acetylcholine they produce decreases, which means nerve signals do not reach the muscles properly. It's not known what triggers the immune system to attack the nerves. It's often associated with lung cancer, but can occur in people without cancer. LEMS is not inherited.

How does small cell cancer cause Lambert-Eaton?

In about 50 to 60 percent of cases, LEMS is associated with an underlying disease, particularly small cell lung cancer. It is thought that the body's attempt to fight the cancer inadvertently causes it to attack nerve endings because cancer cells share some of the same proteins as nerve endings.

What happens in Lambert-Eaton syndrome?

Lambert-Eaton myasthenic syndrome (LEMS) is a rare autoimmune disorder of the neuromuscular junction. It is a miscommunication between the nerve cell and the muscles that lead to the gradual onset of muscle weakness. It starts in the proximal muscles of the legs or arms.

What is the characteristic feature of Eaton Lambert Syndrome?

The most frequent clinical manifestations of Lambert-Eaton myasthenic syndrome are proximal muscle weakness, autonomic dysfunction, and absent deep tendon reflexes. Symptoms are usually insidious in onset and progress more rapidly in SCLC-LEMS.

Is Lambert-Eaton a disability?

Lambert–Eaton myasthenic syndrome (LEMS, Lambert–Eaton syndrome, Eaton–Lambert syndrome) is defined as a rare autoimmune disorder characterized by muscle weakness of the limbs.

What type of doctor treats Lambert-Eaton syndrome?

Neurologists. Physicians who specialize in conditions that affect the nervous system, including the brain, the spinal cord, and all the nerves in the body.

Which of the following is most likely associated with Lambert-Eaton syndrome?

What causes Lambert-Eaton syndrome? This condition is often associated with a certain type of cancer called small cell lung cancer. This syndrome may result from your body's efforts to fight the underlying cancer.

How long can you live with LEMS?

As SCLC (see this term) is a very aggressive cancer, prognosis of patients with LEMS and SCLC is often rather poor. Median survival is 17-24 months, although the amount of patients with long-standing remission or cured is approximately 20% (compared to <2% of patients with a SCLC without LEMS).

Is Lambert-Eaton syndrome progressive?

. Lambert-Eaton myasthenic syndrome has a more progressive course in patients with lung cancer.

What is the difference between myasthenia gravis and Lambert-Eaton syndrome?

The difference between LEMS and myasthenia gravis (MG) This is very similar to myasthenia gravis, however the target of the attack is different in MG as the acetylcholine receptor on the nerve is affected, whereas in LEMS it's the voltage-gated calcium channel on the nerve.

Are LEMS painful?

Symptoms of Lambert-Eaton myasthenic syndrome (LEMS) usually begin insidiously and progress slowly. Many patients have symptoms for months or years before the diagnosis is made. Weakness is the major symptom. Weak muscles may ache and are occasionally tender.

What blood test is used to diagnose LEMS?

In addition, if the physical exam is consistent with LEMS and if the EMG is suggestive of LEMS, the neurologist usually orders a blood test designed to detect antibodies to calcium channels on the nerve side of the nerve-muscle junction.