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Myasthenia gravis Lambert-Eaton overlap syndrome
1Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama.
Introduction:
To assess whether a myasthenia gravis (MG) Lambert-Eaton overlap syndrome (MLOS) exists.
Methods:
Case reports that met the universally accepted diagnostic criteria for MG and Lambert-Eaton myasthenic syndrome (LEMS) were sought through a PubMed search. Fifty-five possible cases of MLOS were identified.
Results:
Thirty-nine cases met the diagnostic criteria for MG and LEMS. Analysis of clinical features showed that these patients have common MG and LEMS symptoms: oculo-bulbar paresis and good response to anti-cholinesterase for MG and limb weakness and decreased or absent reflexes for LEMS. All had the classical LEMS pattern in the repetitive nerve stimulation test: low compound muscle action potential amplitude and incremental response > 60% with brief exercise or at high rate of stimulation. Eight patients had combined positive acetylcholine receptor antibody (AChR-ab) or muscle-specific kinase-ab and voltage-gated calcium channel- ab tests.
Conclusions:
A myasthenia gravis Lambert-Eaton overlap syndrome (MLOS) does exist.
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