Asymptomatic Lambert-Eaton syndrome

Area of Science:

• Neurology
• Clinical Electrophysiology
• Autoimmunity

Background:

• Lambert-Eaton syndrome (LES) is typically described in symptomatic individuals.
• This case presents incidental electromyographic findings suggestive of LES in an asymptomatic patient.
• The patient had controlled hypothyroidism and a history of smoking but no weakness or cancer.

Observation:

• Electrophysiological and serological evaluations were performed.
• Neuromuscular transmission tests indicated a presynaptic disorder.
• The patient had autoantibodies specific for P/Q-type voltage-gated calcium channels (VGCC) in serum.

Findings:

• Asymptomatic LES was identified and persisted for 8 years.
• P/Q-type VGCC autoantibodies were detected and remained throughout the follow-up period.
• Markers of thyrogastric autoimmunity were also present.

Implications:

• This case provides novel insight into the natural history of subclinical LES.
• Patients with subclinical LES may experience abrupt neuromuscular decompensation when exposed to certain medications.
• Understanding subclinical LES is crucial for managing neuromuscular disorders and patient safety.