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Asymptomatic lambert–eaton syndrome
Author(s) -
Denys Eric H.,
Len Vanda A.
Publication year - 2014
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.24126
Subject(s) - asymptomatic , medicine , lambert eaton myasthenic syndrome , surgery , psychiatry , myasthenia gravis
ABSTRACT Introduction All descriptions of the Lambert–Eaton syndrome are based on symptomatic patients. We incidentally encountered electromyographic evidence of this syndrome in a patient being studied for another reason. The patient had controlled hypothyroidism and smoked for 9 pack‐years but never had symptoms of weakness or had evidence of cancer. Methods : Detailed electrophysiological and serological evaluations were undertaken in this study. Results : Neuromuscular transmission tests were consistent with a presynaptic disorder. Autoantibodies specific for P/Q‐type voltage‐gated calcium channels (VGCC) were detected in the serum and persisted throughout 7 years of follow‐up. Multiple IgG markers of thyrogastric autoimmunity also were detected. Conclusions : This demonstration of asymptomatic Lambert–Eaton syndrome persisting for 8 years provided novel insight into the natural history of the disorder. It is plausible that patients with a subclinical syndrome would have abrupt neuromuscular decompensation when challenged with medications that compromise the safety factor for synaptic transmission. Muscle Nerve 49 : 764–767, 2014