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1.
Rev. clín. med. fam ; 15(1): 60-62, Feb. 2022. ilus, graf
Article in Spanish | IBECS | ID: ibc-209825

ABSTRACT

El síndrome de Eaton Lambert es un trastorno de tipo autoinmune que afecta a la unión neuromuscular. Cursa con debilidad muscular proximal y simétrica y en el 60% de los casos se asocia a una neoplasia subyacente. Dado que esta debilidad es de inicio insidioso, los pacientes suelen consultar inicialmente a su especialista de Medicina Familiar y Comunitaria. Reconocer esta entidad es fundamental para el diagnóstico precoz de la enfermedad oncológica ya que habitualmente precede en meses a los síntomas locales derivados de la enfermedad tumoral. El médico o médica de Atención Primaria tiene un papel fundamental en el adelanto diagnóstico y debe realizar una derivación precoz al medio hospitalario para completar el estudio. Presentamos un caso clínico de síndrome de Eaton Lambert paraneoplásico en el contexto de un carcinoma de pulmón de células pequeñas que trata de ilustrar esta cronología y abordar el proceso diagnóstico y terapéutico.(AU)


Eaton Lambert syndrome is an autoimmune disorder that involves the neuromuscular junction. Clinical course includes proximal muscular weakness and symmetry. In 60% of cases this is associated with underlying neoplasia. Given that this weakness is of insidious onset, patients usually initially consult their family doctor. Recognizing this condition is essential for early diagnosis of oncological disease as it usually occurs a few months prior to local symptoms arising from tumour disease. The family doctor plays a crucial role in early diagnosis and should refer early to hospital to complete the study. We report a case study of paraneoplastic Eaton Lambert syndrome in the context of a small cell lung carcinoma that tries to depict this chronology, in addition to tackling the diagnostic and therapeutic process.(AU)


Subject(s)
Humans , Male , Middle Aged , Lambert-Eaton Myasthenic Syndrome/diagnostic imaging , Lambert-Eaton Myasthenic Syndrome/diagnosis , Neuromuscular Junction , Neoplasms/diagnosis , Early Diagnosis , Small Cell Lung Carcinoma , Physical Examination , Symptom Assessment , Treatment Outcome , Family Practice , Autoimmune Diseases , Neuromuscular Junction Diseases
2.
Clin Nucl Med ; 43(9): 697-698, 2018 Sep.
Article in English | MEDLINE | ID: mdl-30080186

ABSTRACT

A 46-year-old woman suffering from lower extremity weakness, dysarthria, dysphagia, dyspnea, and dry mouth was suspected of having Lambert-Eaton myasthenic syndrome based on the characteristic electromyographic abnormalities of right ulnar nerve, which demonstrated reduced resting compound muscle action potential amplitude and greater than 100% incremental change in high-frequency repetitive nerve stimulation. An F-FDG PET/CT was performed to detect the underlying neoplasm and revealed a retroperitoneal soft tissue mass with high F-FDG avidity in the left iliac fossa. The patient's symptoms were prominently relieved after the tumor resection, and the histopathology indicated a small cell carcinoma.


Subject(s)
Carcinoma, Small Cell/diagnostic imaging , Lambert-Eaton Myasthenic Syndrome/diagnostic imaging , Positron Emission Tomography Computed Tomography , Retroperitoneal Neoplasms/diagnostic imaging , Carcinoma, Small Cell/complications , Female , Fluorodeoxyglucose F18 , Humans , Lambert-Eaton Myasthenic Syndrome/complications , Middle Aged , Radiopharmaceuticals , Retroperitoneal Neoplasms/complications
3.
J Clin Neuromuscul Dis ; 19(2): 84-88, 2017 Dec.
Article in English | MEDLINE | ID: mdl-29189554

ABSTRACT

OBJECTIVE: To characterize Lambert-Eaton myasthenic syndrome and limbic encephalitis with coexistent voltage-gated calcium channel (VGCC) antibody and γ-aminobutyric acid (GABA) B receptor antibody. METHODS: Case study. RESULTS: A 57-year-old man presented with 6 months of weakness, unsteadiness, and vision difficulties. Examination revealed proximal weakness and diminished reflexes. Electrodiagnostic study revealed low-amplitude motor potentials and facilitation on high-frequency stimulation. Laboratory evaluation identified P/Q-type VGCC antibody. Positron emission tomography identified a mediastinal lesion, confirmed as small-cell lung carcinoma. The patient developed confusion and seizures. Cerebrospinal fluid analysis identified antibodies to GABAB receptor. CONCLUSIONS: This case describes a patient with Lambert-Eaton myasthenic syndrome, limbic encephalitis, and autoantibodies to VGCC and GABAB receptor. Atypical presentation of paraneoplastic neurological syndromes could indicate the presence of a second antibody that may have significant impact on therapy.


Subject(s)
Autoantibodies/metabolism , Calcium Channels/immunology , Lambert-Eaton Myasthenic Syndrome/complications , Limbic Encephalitis/complications , Receptors, GABA-B/immunology , Aged , Diabetes Mellitus/physiopathology , Humans , Lambert-Eaton Myasthenic Syndrome/diagnostic imaging , Limbic Encephalitis/diagnostic imaging , Male , Positron-Emission Tomography
4.
Medicine (Baltimore) ; 96(22): e6484, 2017 Jun.
Article in English | MEDLINE | ID: mdl-28562525

ABSTRACT

RATIONALE: The Lambert-Eaton myasthenic syndrome (LEMS) is a neuromuscular disease; its unique symptoms of LEMS include dry mouth with a metallic taste, constipation, and erectile dysfunction. As it is quite rare, isolated ocular muscle impairment associated with LEMS east to ignore. PATIENT CONCERNS: A 65-year-old man presented with alternating ptosis and diplopia. Isolated ocular muscle impairment had lasted for 6 years, and the patient was initially diagnosed with ocular myasthenia gravis (MG). Treatment with azathioprine only slightly improved symptoms over the first 2 months; long-term treatment was not effective. DIAGNOSES: Dynamic observation of chest computed tomography images revealed a slowly progressing nodule in the lower lobe of the left lung. The subsequent pathologic examination following mass resection confirmed a diagnosis of lung adenocarcinoma. INTERVENTIONS: The patient was ultimately diagnosed with the Lambert-Eaton myasthenic syndrome associated with pulmonary adenocarcinoma. OUTCOMES: Resection of the lung tumor relieved all symptoms. LESSONS: Other causes of ocular MG symptoms should be considered when standard MG therapy is ineffective, especially the Lambert-Eaton myasthenic syndrome.


Subject(s)
Adenocarcinoma/complications , Lambert-Eaton Myasthenic Syndrome/complications , Lung Neoplasms/complications , Ophthalmoplegia/etiology , Adenocarcinoma/diagnostic imaging , Adenocarcinoma/pathology , Adenocarcinoma/surgery , Adenocarcinoma of Lung , Aged , Diagnosis, Differential , Humans , Lambert-Eaton Myasthenic Syndrome/diagnostic imaging , Lambert-Eaton Myasthenic Syndrome/drug therapy , Lambert-Eaton Myasthenic Syndrome/surgery , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/pathology , Lung Neoplasms/surgery , Male , Ophthalmoplegia/diagnostic imaging , Ophthalmoplegia/drug therapy , Ophthalmoplegia/surgery
7.
Oncology ; 78(2): 150-6, 2010.
Article in English | MEDLINE | ID: mdl-20389137

ABSTRACT

Paraneoplastic neurological syndromes are immune-mediated effects of cancer that involve the nervous system and are associated with various anti-neuronal antibodies. They can be associated with several cancers such as lung, gynecologic, thymic, testicular and others, but the diagnosis of cancer often becomes a challenge, since paraneoplastic neurological syndromes usually precede the cancer presentation by months or even years. Furthermore, even when the cancer develops, the tumor size remains small and usually undetectable by conventional diagnostic tests and imaging. Positron emission tomography imaging may be an adjunct to timely diagnosis of the occult malignancy in order to employ the specific cancer treatment. Furthermore, positron emission tomography can assess the extent of the functional abnormality in the brain and monitor its response to treatment.


Subject(s)
Paraneoplastic Syndromes, Nervous System/diagnostic imaging , Paraneoplastic Syndromes/diagnostic imaging , Positron-Emission Tomography , Breast Neoplasms/diagnostic imaging , Breast Neoplasms/pathology , Dementia/etiology , Diagnosis, Differential , Female , Fluorodeoxyglucose F18 , Humans , Immunotherapy/methods , Lambert-Eaton Myasthenic Syndrome/diagnostic imaging , Magnetic Resonance Imaging , Ovarian Neoplasms/diagnostic imaging , Ovarian Neoplasms/pathology , Paraneoplastic Syndromes/diagnosis , Paraneoplastic Syndromes/pathology , Paraneoplastic Syndromes, Nervous System/diagnosis , Paraneoplastic Syndromes, Nervous System/immunology , Radiopharmaceuticals , Seizures/etiology , Tomography, X-Ray Computed
8.
J Neuroimmunol ; 217(1-2): 90-4, 2009 Dec 10.
Article in English | MEDLINE | ID: mdl-19833394

ABSTRACT

In about 40% of patients LEMS is not a paraneoplastic phenomenon (NT-LEMS). Several clinical aspects important to these patients remain open, especially the question when a LEMS can definitely be diagnosed as NT-LEMS. Here we describe a series of 25 German NT-LEMS patients regarding their clinical characteristics, duration of symptoms, value of serological markers, paraneoplastic antibodies and FDG-PET/CT. Furthermore, we discuss the current diagnostic criteria of NT-LEMS.


Subject(s)
Lambert-Eaton Myasthenic Syndrome/diagnosis , Lambert-Eaton Myasthenic Syndrome/therapy , Adolescent , Adult , Aged , Child , Diagnosis, Differential , Female , Fluorodeoxyglucose F18 , Germany , Humans , Lambert-Eaton Myasthenic Syndrome/diagnostic imaging , Lambert-Eaton Myasthenic Syndrome/physiopathology , Male , Middle Aged , Phosphopyruvate Hydratase/metabolism , Positron-Emission Tomography/methods , Young Adult
10.
Tuberk Toraks ; 53(2): 177-80, 2005.
Article in Turkish | MEDLINE | ID: mdl-16100656

ABSTRACT

Lambert-Eaton myasthenic syndrome (LEMS) is a rare type of neuromusculer conduction disorder. This disease can be seen with lung cancer and, it is associated with otoimmunity. Among the symptoms of lung cancer LEMS can be seen, but it is very rare. In this case, LEMS symptoms were analyzed before lung cancer symptoms. The localization of the tumor was near the pulmonary artery. By the early diagnose, the patient had the chance of cure.


Subject(s)
Lambert-Eaton Myasthenic Syndrome/diagnosis , Aged , Carcinoma, Large Cell/complications , Carcinoma, Large Cell/diagnosis , Carcinoma, Large Cell/diagnostic imaging , Carcinoma, Large Cell/pathology , Carcinoma, Small Cell/complications , Carcinoma, Small Cell/diagnosis , Carcinoma, Small Cell/diagnostic imaging , Carcinoma, Small Cell/pathology , Diagnosis, Differential , Humans , Lambert-Eaton Myasthenic Syndrome/complications , Lambert-Eaton Myasthenic Syndrome/diagnostic imaging , Lambert-Eaton Myasthenic Syndrome/pathology , Lung Neoplasms/complications , Lung Neoplasms/diagnosis , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/pathology , Male , Neoplasms, Multiple Primary/complications , Neoplasms, Multiple Primary/diagnosis , Neoplasms, Multiple Primary/diagnostic imaging , Neoplasms, Multiple Primary/pathology , Radiography
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