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Lambert-Eaton Myasthenic Syndrome.
1Department of Clinical Neurology, University of Oxford, Radcliffe Infirmary, Oxford, OX2 6HE, UK.
Current Treatment Options in Neurology
|February 17, 2001
Summary
Lambert-Eaton myasthenic syndrome (LEMS) management involves symptomatic treatments like 3,4-Diaminopyridine and immunotherapy for severe cases. For paraneoplastic LEMS, addressing underlying lung cancer is crucial for neurological improvement.
Area of Science:
- Neurology
- Immunology
- Oncology
Background:
- Lambert-Eaton myasthenic syndrome (LEMS) presents with muscle weakness and autonomic dysfunction.
- Paraneoplastic LEMS is frequently associated with lung cancer, particularly in smokers.
Purpose of the Study:
- To outline current therapeutic strategies for Lambert-Eaton myasthenic syndrome.
- To emphasize the importance of identifying and treating the underlying cause in paraneoplastic LEMS.
Main Methods:
- Symptomatic treatment with 3,4-Diaminopyridine.
- Immunotherapies including intravenous immunoglobulin and plasma exchange for severe cases.
- Cancer screening and treatment for suspected paraneoplastic LEMS.
Main Results:
- 3,4-Diaminopyridine offers partial to full control of LEMS symptoms.
- Immunotherapies provide short-term benefits for severely affected individuals.
- Treating the underlying malignancy in paraneoplastic LEMS can improve neurological deficits.
Conclusions:
- Prednisolone is indicated for LEMS patients unresponsive to symptomatic treatment.
- Azathioprine or cyclosporine can be used as corticosteroid-sparing agents in nonparaneoplastic LEMS.
- Treatment should be tailored, with consideration for switching immunosuppressants if initial therapy fails.