Autonomic dysfunction in Lambert-Eaton myasthenic syndrome

Autonomic symptoms were observed in 6 patients with clinically and electrophysiologically documented Lambert-Eaton myasthenic syndrome (LEMS). Of the 6 patients, 2 were extensively investigated in the laboratory. In contrast to previous reports which recognized only cholinergic dysautonomia, abnormalities of sympathetic as well as parasympathetic function were evident. Of the 6 patients, 4 had small cell lung cancer (SCLC). In one male patient, chemotherapy for SCLC resulted in an early improvement of autonomic dysfunction and the electrophysiological defect, documenting simultaneous regression of dysautonomia and LEMS. In addition, the patients with SCLC and LEMS had a survival thus far of 3-13 years suggesting that a subgroup of SCLC patients have a better prognosis.