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Published on: October 25, 2018
A patient with coexisting myasthenia gravis and lambert-eaton myasthenic syndrome
Jee-Ae Kim1, Young-Min Lim, Eun Hye Jang
1Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Background:
The coexistence of myasthenia gravis (MG) and Lambert-Eaton myasthenic syndrome (LEMS) is very rare and remains controversial.
Case Report:
A 48-year-old woman initially presented with noticeable right ptosis and intermittent diplopia. She then developed fluctuating proximal limb weakness and difficulty in swallowing. The serum titer of anti-acetylcholine-receptor antibody was elevated and the edrophonium (Tensilon) test was positive. However, repetitive nerve stimulation revealed abnormalities typical of LEMS. The patient exhibited a good response to treatment with anticholinesterase inhibitors and steroids, and long-term evaluation disclosed that she presented with the clinical, electrophysiological, and immunological characteristics of both diseases.
Conclusions:
The reported clinical and electrophysiological features suggest that this patient was a very rare case of combined MG and LEMS.
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