Non-paraneoplastic Lambert-Eaton myasthenic syndrome: a brief review of 10 cases
Lambert-Eaton myasthenic syndrome (LEMS) is an immune-mediated disorder of the presynaptic neuromuscular transmission, which more frequently occurs as the remote effect of a neoplasm, in the paraneoplastic form (P-LEMS), or in a non-paraneoplastic form (NP-LEMS); but few studies describe the clinical features of NP-LEMS. We analyzed the clinical manifestations, laboratory findings, electrophysiological studies, and treatment responses in ten Brazilian patients suffering from NP-LEMS. The mean age was 41.5 years. More often neurological findings were hyporeflexia or areflexia with a post-exercise improvement. Treatment response occurred with pyridostigmine, guanidine, prednisone, azathioprine, and cyclosporine; but not response was observed after intravenous immunoglobulin and plasma exchange. Age at onset, clinical manifestations, and electrophysiological abnormalities can help more in the diagnosis than serum antibodies; the symptomatic treatment with pyridostigmine was effective; and the immunosuppressive treatment with prednisone, azathioprine, or cyclosporine was more beneficial than plasma exchange or intravenous immunoglobulin treatment.
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Academia Brasileira de Neurologia - ABNEURO
2010
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oai:scielo:S0004-282X20100006000042011-01-06Non-paraneoplastic Lambert-Eaton myasthenic syndrome: a brief review of 10 casesLorenzoni,Paulo J.Scola,Rosana H.Kay,Cláudia S. KamoiParolin,Sérgio F.Werneck,Lineu C. Lambert-Eaton myasthenic syndrome myasthenic syndrome P/Q-type voltage-gated calcium channel antibody repetitive nerve stimulation electrophysiological study treatment Lambert-Eaton myasthenic syndrome (LEMS) is an immune-mediated disorder of the presynaptic neuromuscular transmission, which more frequently occurs as the remote effect of a neoplasm, in the paraneoplastic form (P-LEMS), or in a non-paraneoplastic form (NP-LEMS); but few studies describe the clinical features of NP-LEMS. We analyzed the clinical manifestations, laboratory findings, electrophysiological studies, and treatment responses in ten Brazilian patients suffering from NP-LEMS. The mean age was 41.5 years. More often neurological findings were hyporeflexia or areflexia with a post-exercise improvement. Treatment response occurred with pyridostigmine, guanidine, prednisone, azathioprine, and cyclosporine; but not response was observed after intravenous immunoglobulin and plasma exchange. Age at onset, clinical manifestations, and electrophysiological abnormalities can help more in the diagnosis than serum antibodies; the symptomatic treatment with pyridostigmine was effective; and the immunosuppressive treatment with prednisone, azathioprine, or cyclosporine was more beneficial than plasma exchange or intravenous immunoglobulin treatment.info:eu-repo/semantics/openAccessAcademia Brasileira de Neurologia - ABNEUROArquivos de Neuro-Psiquiatria v.68 n.6 20102010-12-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2010000600004en10.1590/S0004-282X2010000600004 |
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Lorenzoni,Paulo J. Scola,Rosana H. Kay,Cláudia S. Kamoi Parolin,Sérgio F. Werneck,Lineu C. |
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Lorenzoni,Paulo J. Scola,Rosana H. Kay,Cláudia S. Kamoi Parolin,Sérgio F. Werneck,Lineu C. Non-paraneoplastic Lambert-Eaton myasthenic syndrome: a brief review of 10 cases |
author_facet |
Lorenzoni,Paulo J. Scola,Rosana H. Kay,Cláudia S. Kamoi Parolin,Sérgio F. Werneck,Lineu C. |
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Lorenzoni,Paulo J. |
title |
Non-paraneoplastic Lambert-Eaton myasthenic syndrome: a brief review of 10 cases |
title_short |
Non-paraneoplastic Lambert-Eaton myasthenic syndrome: a brief review of 10 cases |
title_full |
Non-paraneoplastic Lambert-Eaton myasthenic syndrome: a brief review of 10 cases |
title_fullStr |
Non-paraneoplastic Lambert-Eaton myasthenic syndrome: a brief review of 10 cases |
title_full_unstemmed |
Non-paraneoplastic Lambert-Eaton myasthenic syndrome: a brief review of 10 cases |
title_sort |
non-paraneoplastic lambert-eaton myasthenic syndrome: a brief review of 10 cases |
description |
Lambert-Eaton myasthenic syndrome (LEMS) is an immune-mediated disorder of the presynaptic neuromuscular transmission, which more frequently occurs as the remote effect of a neoplasm, in the paraneoplastic form (P-LEMS), or in a non-paraneoplastic form (NP-LEMS); but few studies describe the clinical features of NP-LEMS. We analyzed the clinical manifestations, laboratory findings, electrophysiological studies, and treatment responses in ten Brazilian patients suffering from NP-LEMS. The mean age was 41.5 years. More often neurological findings were hyporeflexia or areflexia with a post-exercise improvement. Treatment response occurred with pyridostigmine, guanidine, prednisone, azathioprine, and cyclosporine; but not response was observed after intravenous immunoglobulin and plasma exchange. Age at onset, clinical manifestations, and electrophysiological abnormalities can help more in the diagnosis than serum antibodies; the symptomatic treatment with pyridostigmine was effective; and the immunosuppressive treatment with prednisone, azathioprine, or cyclosporine was more beneficial than plasma exchange or intravenous immunoglobulin treatment. |
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Academia Brasileira de Neurologia - ABNEURO |
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2010 |
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http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2010000600004 |
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