Lambert-Eaton myasthenic syndrome: a clinical contribution

A case of Lambert-Eaton myasthenic syndrome (LEMS) revealed by prolonged apnea following the administration of pancuronium during surgery for squamous cell carcinoma of the lung is reported. The postoperative respiratory failure allowed the correct interpretation of a poor clinical picture:slight weakness of the lower limbs and no other signs of neuromuscular disease. In the authors' opinion prolonged apnea always requires accurate neurophysiological investigation in order to detect latent neuromuscular transmission defects which are frequently underevaluated.