eMedicine Specialties > Neurology > Neuromuscular Diseases

Lambert-Eaton Myasthenic Syndrome: Multimedia

Author: David E Stickler, MD, Assistant Professor, Department of Neurosciences, Director of Electromyography Laboratory, Director of MDA Clinic, Director of Neuromuscular Service, Director of ALS Clinic, Medical University of South Carolina
Coauthor(s): Donald B Sanders, MD, EMG Laboratory Director, Professor of Medicine (Neurology), Division of Neurology, Duke University Medical Center
Contributor Information and Disclosures

Updated: Jan 29, 2009

Multimedia

Characteristic responses to repetitive nerve stim...
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Media file 1: Characteristic responses to repetitive nerve stimulation in a patient with Lambert-Eaton myasthenic syndrome (LEMS). A: Responses elicited from a hand muscle by stimulation of the nerve at 3 Hz. Amplitude of the initial response is less than normal and the response is decremental. B: Responses as in A, immediately after voluntary activation of the muscle for 10 seconds. Amplitude has increased. C: Responses in a hand muscle elicited by 20-Hz stimulation of the nerve for 10 seconds. Response amplitude is less than normal initially, falls further during the first few stimuli, then increases and ultimately becomes more than twice the initial value.
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Characteristic responses to repetitive nerve stim...

Characteristic responses to repetitive nerve stimulation in a patient with Lambert-Eaton myasthenic syndrome (LEMS). A: Responses elicited from a hand muscle by stimulation of the nerve at 3 Hz. Amplitude of the initial response is less than normal and the response is decremental. B: Responses as in A, immediately after voluntary activation of the muscle for 10 seconds. Amplitude has increased. C: Responses in a hand muscle elicited by 20-Hz stimulation of the nerve for 10 seconds. Response amplitude is less than normal initially, falls further during the first few stimuli, then increases and ultimately becomes more than twice the initial value.

Compound muscle action potentials elicited from a...
(Enlarge Image)
Media file 2: Compound muscle action potentials elicited from a hand muscle before and immediately after maximal voluntary activation of the muscle for 10 seconds. The amplitude is small initially, increasing almost 10 times after activation.
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Compound muscle action potentials elicited from a...

Compound muscle action potentials elicited from a hand muscle before and immediately after maximal voluntary activation of the muscle for 10 seconds. The amplitude is small initially, increasing almost 10 times after activation.

More on Lambert-Eaton Myasthenic Syndrome

Overview: Lambert-Eaton Myasthenic Syndrome
Differential Diagnoses & Workup: Lambert-Eaton Myasthenic Syndrome
Treatment & Medication: Lambert-Eaton Myasthenic Syndrome
Follow-up: Lambert-Eaton Myasthenic Syndrome
Multimedia: Lambert-Eaton Myasthenic Syndrome
References
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References

  1. Sabater L, Titulaer M, Saiz A, Verschuuren J, Güre AO, Graus F. SOX1 antibodies are markers of paraneoplastic Lambert-Eaton myasthenic syndrome. Neurology. March 2008;70:924-928. [Medline].

  2. Chalk CH, Murray NM, Newsom-Davis J, et al. Response of the Lambert-Eaton myasthenic syndrome to treatment of associated small-cell lung carcinoma. Neurology. Oct 1990;40(10):1552-6. [Medline].

  3. Elmqvist D, Lambert EH. Detailed analysis of neuromuscular transmission in a patient with the myasthenic syndrome sometimes associated with bronchogenic carcinoma. Mayo Clin Proc. Oct 1968;43(10):689-713. [Medline].

  4. Lambert EH, Eaton LM, Rooke ED. Defect of neuromuscular conduction associated with malignant neoplasms. Am J Physiol. 1956;187:612-613. [Medline].

  5. Lennon VA. Serological profile of myasthenia gravis and distinction from the Lambert-Eaton myasthenic syndrome. Neurology. 1997;48 (Suppl 5):S23-S27. [Medline].

  6. Lennon VA, Kryzer TJ, Griesmann GE, et al. Calcium-channel antibodies in the Lambert-Eaton syndrome and other paraneoplastic syndromes. N Engl J Med. Jun 1 1995;332(22):1467-74. [Medline].

  7. Lundh H, Nilsson O, Rosen I. Novel drug of choice in Eaton-Lambert syndrome. J Neurol Neurosurg Psychiatry. Jul 1983;46(7):684-5. [Medline].

  8. Lundh H, Nilsson O, Rosen I, Johansson S. Practical aspects of 3,4-diaminopyridine treatment of the Lambert-Eaton myasthenic syndrome. Acta Neurol Scand. Aug 1993;88(2):136-40. [Medline].

  9. McEvoy KM, Windebank AJ, Daube JR, Low PA. 3,4-Diaminopyridine in the treatment of Lambert-Eaton myasthenic syndrome. N Engl J Med. Dec 7 1989;321(23):1567-71. [Medline].

  10. O'Neill JH, Murray NM, Newsom-Davis J. The Lambert-Eaton myasthenic syndrome. A review of 50 cases. Brain. Jun 1988;111 ( Pt 3):577-96. [Medline].

  11. Pellkofer HL, Armbruster L, Krumbholz M, Titulaer MJ, Verschuuren JJ, Schumm F, et al. Lambert-Eaton myasthenic syndrome differential reactivity of tumor versus non-tumor patients to subunits of the voltage-gated calcium channel. Journal of Neuroimmunology. 2008;epub ahead of print:[Medline].

  12. Sanders DB. Lambert-Eaton myasthenic syndrome: clinical diagnosis, immune-mediated mechanisms, and update on therapies. Ann Neurol. May 1995;37 Suppl 1:S63-73. [Medline].

  13. Sanders DB, Massey JM, Sanders LL, Edwards LJ. A randomized trial of 3,4-diaminopyridine in Lambert-Eaton myasthenic syndrome. Neurology. Feb 8 2000;54(3):603-7. [Medline].

  14. Tim RW, Massey JM, Sanders DB. Lambert-Eaton myasthenic syndrome (LEMS). Clinical and electrodiagnostic features and response to therapy in 59 patients. Ann N Y Acad Sci. May 13 1998;841:823-6. [Medline].

  15. Tim RW, Sanders DB. Repetitive nerve stimulation studies in the Lambert-Eaton myasthenic syndrome. Muscle Nerve. Sep 1994;17(9):995-1001. [Medline].

  16. Wirtz PW, Bradshaw J, Wintzen AR, Verschuuren JJ. Associated autoimmune diseases in patients with the Lambert-Eaton myasthenic syndrome and their families. J Neurol. Oct 2004;251(10):1255-9. [Medline].

  17. Wirtz PW, Wintzen AR, Verschuuren JJ. Lambert-Eaton myasthenic syndrome has a more progressive course in patients with lung cancer. Muscle Nerve. Aug 2005;32(2):226-9. [Medline].

  18. Zambelis T, Foutsitzi A, Giannakopoulou A, et al. Lambert-Eaton myasthenic syndrome. Clinical and electrophysiological findings in seven cases. Electromyogr Clin Neurophysiol. Jul-Aug 2004;44(5):289-92. [Medline].

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Further Reading

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Keywords

Lambert-Eaton myasthenic syndrome, LEMS, acetylcholine release, ACh release, neuromuscular transmission, small cell lung cancer, SCLC, non-SCLC lung cancer, non–small cell lung cancer, lymphosarcoma, malignant thymoma, carcinoma of the breast, carcinoma of the stomach, carcinoma of the colon, carcinoma of the prostate, carcinoma of the bladder, carcinoma of the kidney, carcinoma of the gallbladder

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Contributor Information and Disclosures

Author

David E Stickler, MD, Assistant Professor, Department of Neurosciences, Director of Electromyography Laboratory, Director of MDA Clinic, Director of Neuromuscular Service, Director of ALS Clinic, Medical University of South Carolina
David E Stickler, MD is a member of the following medical societies: American Academy of Neurology and American Association of Neuromuscular and Electrodiagnostic Medicine
Disclosure: Nothing to disclose.

Coauthor(s)

Donald B Sanders, MD, EMG Laboratory Director, Professor of Medicine (Neurology), Division of Neurology, Duke University Medical Center
Donald B Sanders, MD is a member of the following medical societies: American Academy of Neurology, American Association of Neuromuscular and Electrodiagnostic Medicine, American Neurological Association, and New York Academy of Sciences
Disclosure: Nothing to disclose.

Medical Editor

Paul E Barkhaus, MD, Professor, Department of Neurology, Medical College of Wisconsin; Director of Neuromuscular Diseases, Milwaukee Veterans Administration Medical Center
Paul E Barkhaus, MD is a member of the following medical societies: American Academy of Neurology, American Association of Neuromuscular and Electrodiagnostic Medicine, and American Neurological Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Neil A Busis, MD, Chief, Division of Neurology, Department of Medicine, Head, Clinical Neurophysiology Laboratory, University of Pittsburgh Medical Center-Shadyside
Neil A Busis, MD is a member of the following medical societies: American Academy of Neurology and American Association of Neuromuscular and Electrodiagnostic Medicine
Disclosure: Nothing to disclose.

CME Editor

Selim R Benbadis, MD, Professor, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, University of South Florida School of Medicine, Tampa General Hospital
Selim R Benbadis, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, American Clinical Neurophysiology Society, American Epilepsy Society, and American Medical Association
Disclosure: Nothing to disclose.

Chief Editor

Nicholas Y Lorenzo, MD, Chief Editor, eMedicine Neurology; Consulting Staff, Neurology Specialists and Consultants
Nicholas Y Lorenzo, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Neurology
Disclosure: Nothing to disclose.

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