Lambert-Eaton Myasthenic Syndrome (LEMS)

Question 1

Presentation

Answer 1

• Similar features to myasthenia gravis

Question 2

Pathophysiology of LEMS

Answer 2

• Typically occurs in small cell lung cancer
• Antibodies produced against voltage-gated calcium channels in SCLC
• These channels are in the presynaptic terminals of the NMJ where motor nerves communicate with muscle cells and are responsible for assisting in the release of ACh

Question 3

Management of LEMS

Answer 3

• Manage underlying malignancy
• Amifampridine allows more ACh to be released
• Can also use immunosuppresants, IVIG and plasmapheresis