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• #1 Lambert-Eaton myasthenic syndrome

  https://www.nhs.uk/conditions/lambert-eaton-myasthenic-syndrome/

  Lambert-Eaton myasthenic syndrome (LEMS) is a rare condition that affects the signals sent from the nerves to the muscles. It means the muscles are unable to tighten (contract) properly, resulting in muscle weakness and a range of other symptoms. […] The symptoms of LEMS develop gradually over weeks or months. The main symptoms are weakness in the legs, arms, neck and face, as well as problems with automatic body functions, such as controlling blood pressure. […] Common symptoms include: aching muscles, feeling very tired all the time (fatigue), difficulty walking and climbing stairs, difficulty lifting objects or raising the arms, drooping eyelids, dry eyes and blurred vision, swallowing problems, dizziness upon standing, a dry mouth, constipation, erectile dysfunction, muscle weakness that gets worse with time.

• #1 Lambert-Eaton Myasthenic Syndrome (LEMS): Symptoms & Causes

  https://my.clevelandclinic.org/health/diseases/23202-lambert-eaton-myasthenic-syndrome-lems

  Lambert-Eaton myasthenic syndrome symptoms include: […] Muscle weakness is a common symptom. […] This weakness usually begins in your upper legs, but can come to involve other muscle groups in your arms, as well as muscles involved in breathing, swallowing and speech. […] Symptoms of LEMS can begin many months or years before the cancer develops or is diagnosed. […] Lambert-Eaton myasthenic syndrome typically affects leg muscle strength (upper leg) first, followed by shoulder muscles, muscles of your hands and feet, muscles affecting your speech and swallowing, and eye muscles. […] Symptoms usually develop slowly over weeks to many months. Symptoms develop more quickly if you have cancer and LEMS. […] Trouble speaking (dysarthria) and trouble swallowing (dysphagia). These are late-stage symptoms. […] Trouble breathing (dyspnea) and respiratory failure. This is an uncommon, late-stage symptom.

• #1 Lambert-Eaton Disease: Symptoms, Causes and Treatment

  https://lonestarneurology.net/blog/lambert-eaton-disease/

  As the myasthenic disease progresses, you will also experience: […] – When the patient is interviewed, they complain of leg weakness and instability of movement, which is more pronounced when walking and climbing stairs for long periods of time; […] – Patients with Lambert-Eaton disease tend to have a paralytic duck-like walk; […] – Tendon reflexes are reduced; […] – Lambert-Eaton syndrome has a definite increase in muscle strength during movement, which distinguishes it from myasthenia gravis, where muscle weakness increases with movement. […] Accompanying symptoms may also include: […] – discomfort in the back and neck; […] – paresthesias in the distal limbs; […] – myalgia; […] – decreased vision acuity; […] – various autonomic disorders, such as decreased lacrimation, dry mouth, orthostatic arterial hypotension, and distal hyperhidrosis. […] In some cases, upper eyelid drooping is found. Rarely impaired swallowing, double vision, and myasthenia gravis movement disorders have been noticed. […] The Lambert Eaton disease can be progressive without proper treatment and care.

• #1 Lambert-Eaton myasthenic syndrome: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000710.htm

  Lambert-Eaton myasthenic syndrome (LEMS) is a rare disorder in which faulty communication between nerves and muscles leads to muscle weakness. […] Weakness or loss of movement that can be more or less severe, including: Difficulty climbing stairs, walking, or lifting things, Muscle pain, Drooping of the head, The need to use the hands to get up from a sitting or lying position, Problems talking, Problems chewing or swallowing, which may include gagging or choking, Vision changes, such as blurry vision, double vision, and problem keeping a steady gaze. […] Weakness is generally mild in LEMS. Leg muscles are mostly affected. Weakness may improve after exercise, but continuous exertion causes fatigue in some cases. […] Symptoms related to the other parts of the nervous system often occur, and may include: Blood pressure changes, Dizziness upon standing, Dry mouth, Erectile dysfunction, Dry eyes, Constipation, Decreased sweating.

• #1 Lambert-Eaton Myasthenic Syndrome Versus Myasthenia GravisShare to Facebookprint pageBookmark for latercommentcaret iconcaret iconmore actionsFollow us on facebookFollow us on instagramFollow us on facebookFollow us on linkedincaret icon

  https://myasthenia-gravis.com/clinical/lems-symptom-differences

  Myasthenia gravis (MG) and Lambert-Eaton myasthenic syndrome (LEMS) are autoimmune conditions. This means the immune system attacks your own healthy cells. Both conditions involve the immune system interfering with nerves communicating to muscles. This leads to muscle weakness and fatigue in both conditions. However, they are different conditions with different causes and symptoms. […] In LEMS, the immune system attacks the neuromuscular junction. This is where the nerve cells in charge of movement (motor neurons) contact your muscles. Antibodies in your immune system attack calcium channels in this area. This reduces the release of the neurotransmitter acetylcholine. Your muscles then cannot get fully activated. This leads to muscle weakness. […] The main symptoms of MG and LEMS are muscle weakness and fatigue. Muscle weakness can involve many parts of the body. It can lead to: Trouble walking, Difficulty using your hands and arms, Difficulty speaking, swallowing, or chewing, Stiffness.

• #1 Lambert-Eaton Myasthenic Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK507891/

  Lambert-Eaton myasthenic syndrome (LEMS) is a neuromuscular junction disorder affecting communication between nerves and muscles. […] The primary clinical symptom is muscle weakness. […] The predominant clinical features of LEMS include proximal muscle weakness, autonomic dysfunction, and impaired deep tendon reflexes. The symptoms of LEMS typically have an insidious onset and progress more rapidly in cases of SCLC-LEMS. […] Muscle weakness predominantly involves the proximal lower extremities, leading to difficulties transitioning from a seated posture. […] A characteristic feature of LEMS is post-exercise or post-activation facilitation, characterized by enhanced deep tendon reflexes and muscle strength after repeated muscle contractions. […] Oculobulbar weakness is a prominent feature of LEMS, with cranial nerve involvement observed in approximately 70% of patients.

• #1 Lambert-Eaton Myasthenic Syndrome (LEMS) Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/1170810-clinical

  Reflexes usually are reduced or absent in LEMS. They can frequently be provoked or increased by having the patient actively contract the muscle group in question for 10 seconds prior to reflex testing or by repeatedly tapping the muscles. An increase in reflex activity after contraction is a hallmark of LEMS.

• #1 Neuro-Ophthalmic Manifestations of Lambert-Eaton Myasthenic Syndrome – EyeWiki

  https://eyewiki.org/Neuro-Ophthalmic_Manifestations_of_Lambert-Eaton_Myasthenic_Syndrome

  Lambert-Eaton myasthenic syndrome (LEMS) is a neuromuscular junction disorder characterized by presynaptic autoantibodies against voltage-gated calcium channels (VGCCs) and limb weakness that improves after repetitive voluntary muscle movement. LEMS typically presents with hyporeflexia, autonomic dysfunction, and extremity weakness that progresses caudal to cranial and proximal to distal. […] Extremity weakness is the most common complaint and typically presents as symmetric extremity weakness that fluctuates during the day and worsens with warmth. Weakness in the legs is more common than in the arms and leads to difficulty rising from a seated position or climbing stairs. LEMS classically progresses over weeks to months from proximal to distal and caudal to cranial, eventually developing oculobulbar weakness.

• #1 Lambert-Eaton Myasthenic Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK507891/

  Autonomic dysfunction is a prevailing concern in LEMS, affecting a significant proportion of patients, with a prevalence ranging from 80% to 96%. […] Patients diagnosed with LEMS often experience a diminished quality of life due to weakness, autonomic involvement, and potential treatment-related adverse effects. […] The life expectancy of LEMS patients depends on whether it is paraneoplastic or non-paraneoplastic (NT-LEMS). […] LEMS typically presents with a gradual onset and a progressively advancing course.

• #1 Neuro-Ophthalmic Manifestations of Lambert-Eaton Myasthenic Syndrome – EyeWiki

  https://eyewiki.org/Neuro-Ophthalmic_Manifestations_of_Lambert-Eaton_Myasthenic_Syndrome

  Autonomic disturbances, especially anticholinergic, are seen in 80-96% of LEMS patients. In one study, dry mouth was the most frequent complaint found in 75% of patients. Other disturbances included erectile dysfunction, constipation, dry eyes, orthostatic hypotension, anhidrosis, and urinary retention. […] Ocular and bulbar symptoms are reported in 49-78% of LEMS and are usually seen late in the disease as it progresses craniocaudal. Compared to MG, the ocular and bulbar weakness seen in LEMS is typically milder and potentially under-appreciated. […] A Mayo Clinic retrospective review of 167 patients described the ophthalmic symptoms of LEMS including: ptosis (26%), diplopia (20.5%), decreased vision (14%), and dry eye (7%). Ocular signs included ptosis (26%), abnormal ocular motility (8.5%), strabismus (8%), pupillary dysfunction (7%), and dry eyes (2%).

• #1 Lambert-Eaton Myasthenic Syndrome (LEMS) Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/1170810-clinical

  Symptoms of Lambert-Eaton myasthenic syndrome (LEMS) usually begin insidiously and progress slowly. Many patients have symptoms for months or years before the diagnosis is made. Weakness is the major symptom. Weak muscles may ache and are occasionally tender. Proximal muscles are more affected than distal muscles; lower extremity muscles are affected predominantly. Patients typically have difficulty rising from a chair, climbing stairs, and walking. […] Increased temperatures from fever or the environment may worsen the weakness. Patients may experience transient worsening after hot baths and showers or during systemic illnesses. […] The oropharyngeal and ocular muscles are mildly affected in about one quarter of cases of LEMS, with symptoms that may include ptosis, diplopia, and dysarthria, but they are usually not affected to the same extent or severity as in myasthenia gravis (MG).

• #1 Signs and Symptoms of Lambert-Eaton Myasthenic Syndrome (LEMS) – Diseases | Muscular Dystrophy Association

  https://www.mda.org/disease/lambert-eaton-myasthenic-syndrome/signs-and-symptoms

  The proximal weakness is usually slowly progressive. Weakness and fatigue in LEMS can fluctuate from day to day. Stress, heat and lack of sleep may make symptoms worse. Medications (see Medical Management) can help in the management of disease. Over the long term, people without cancer usually do well with treatment, but most continue to have some symptoms. Breathing or swallowing problems are relatively rare and tend to occur later. Individuals with cancer have a more progressive course.

• #1 Lambert-Eaton Myasthenic Syndrome – Samir P. Macwan, MD

  https://socalmusclenerve.com/lambert-eaton-myasthenic-syndrome/

  Lambert-Eaton myasthenic syndrome (LEMS) is a rare autoimmune disorder of the neuromuscular junction. It is a miscommunication between the nerve cell and the muscles that lead to the gradual onset of muscle weakness. It starts in the proximal muscles of the legs or arms. […] LEMS is characterized by weakness and fatigue especially of the muscles in the legs and arms. The disease may affect the patients ability to engage in strenuous exercise and may make such activities as climbing stairs or walking up a steep walkway difficult. Onset is gradual, typically taking place over several weeks to many months. There is often a progression of symptoms whereby the shoulder muscles, muscles of the feet hands, speech swallowing muscles and eye muscles are affected in a stepwise fashion. The symptoms progress more quickly when LEMS is associated with cancer. Most LEMS patients also exhibit the following symptoms (sometimes called autonomic symptoms): dry mouth, dry eyes, constipation, impotence, and decreased sweating. LEMS patients with or without cancer may also undergo significant weight loss. The tendon reflexes are diminished or absent on examination. Hence, in summary, LEMS is often described as a clinical triad of proximal muscle weakness, autonomic symptoms and reduced tendon reflexes.

• #1 Recognizing LEMS | LEMS Aware HCPLEMS Aware logoLEMS Aware on LinkedInLEMS Aware on TwitterLEMS Aware on FacebookCatalyst Logo

  https://www.lemsawarehcp.com/recognizing-lems/

  Lambert-Eaton myasthenic syndrome (LEMS) is an autoimmune disorder of the neuromuscular junction. It causes debilitating and progressive muscle weakness and fatigue, the effects of which leave patients with diminished physical functioning and a poorer quality of life. […] LEMS is progressive and debilitating and may contribute to a high level of disease burden, which can worsen over time. […] In a 2012 study of patients living with LEMS: 75% reported partial or total restriction in activities of daily living, such as rising from a chair or climbing stairs; 50% reported severe leg weakness; other frequently reported symptoms included dry mouth and visual difficulties. […] The progressive nature of LEMS and the diagnostic challenges that it presents make early symptom recognition critical for optimal patient care. […] LEMS is often suspected based on a clinical triad of signs and symptoms: Proximal muscle weakness, Autonomic symptoms (eg, dry mouth, impotence), Hyporeflexia or areflexia. […] „Waddling” is a classic symptom seen in many patients with LEMS prior to treatment.

• #1

  https://link.springer.com/article/10.1007/s00415-024-12206-6

  Lambert-Eaton myasthenic syndrome (LEMS) is an autoimmune-mediated neuromuscular disorder leading to muscle weakness, autonomic dysregulation and hyporeflexia. […] Symptoms include muscle fatigability and proximally pronounced weakness, hypo- or areflexia and autonomous dysregulation. […] LEMS participants showed lower levels of physical functioning (SF-36 mean 34.2 SD 28.6) compared to genP (mean 78.6 SD 21.1) and MG patients (mean 61.3 SD 31.8). […] LEMS patients showed lower mental health sub-scores compared to genP (SF-36 mean 62.7 SD 20.2, vs. 75.7 SD 15.1) and MG patients (SF-36 mean 62.7 SD 20.2, vs. 66.0 SD 18.). […] Depression, anxiety and fatigue were prevalent. […] Most LEMS patients reach maximum disease severity before or within the first year of diagnosis. […] Functional impairment typically improves within 1 year after diagnosis for both autoimmune LEMS (aiLEMS) and pLEMS patients, though pLEMS patients report higher levels of functional impairment throughout the disease course.

• #1 Lambert-Eaton Myasthenic Syndrome (LEMS): Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1170810-overview

  Lambert-Eaton myasthenic syndrome (LEMS) is a rare presynaptic disorder of neuromuscular transmission in which quantal release of acetylcholine (ACh) is impaired, causing a unique set of clinical characteristics, including proximal muscle weakness, depressed tendon reflexes, posttetanic potentiation, and autonomic changes. The initial presentation can be similar to that of myasthenia gravis (MG), but the progressions of the two diseases have some important differences. […] The main problem created by LEMS is the progressive weakness that affects everyday activities and general quality of life. LEMS does not seem to affect the respiratory system as significantly as MG does. In most patients, weakness does not severely affect vital muscles. Maximum severity usually becomes established within several months of symptom onset.

• #1 Diagnosis and Treatment of Lambert-Eaton Myasthenic Syndrome

  https://practicalneurology.com/articles/2024-apr/diagnosis-and-treatment-of-lambert-eaton-myasthenic-syndrome

  Lambert-Eaton myasthenic syndrome (LEMS) is a rare autoimmune presynaptic disorder of the neuromuscular junction (NMJ) associated with weakness, reduced or absent muscle stretch reflexes, and autonomic dysfunction. […] The primary clinical presentation of LEMS is the triad of muscle weakness, reduced or absent reflexes, and autonomic dysfunction. Weakness is most prominent in the proximal legs and arms, with other muscle groups being less severely affected. […] Muscle weakness in LEMS starts in the proximal limbs, particularly the lower extremities and spreads from proximal to distal muscles. […] Prognosis varies depending upon the underlying cause. Individuals with nontumor-associated LEMS have a normal life expectancy but experience chronic symptoms that impair functional abilities and affect quality of life.

• #1 Diagnosis and Treatment of Lambert-Eaton Myasthenic Syndrome

  https://practicalneurology.com/articles/2024-apr/diagnosis-and-treatment-of-lambert-eaton-myasthenic-syndrome

  Individuals with tumor-associated LEMS have a poor long-term survival rate as a result of the associated malignancy. In the context of LEMS associated with SCLC, the median survival is approximately 18 months. […] There is a strong association with cancer, with more than half of LEMS cases being paraneoplastic in etiology, which renders serial cancer screening of critical importance.

• #1 Lambert-Eaton myasthenic syndrome

  https://www.nhs.uk/conditions/lambert-eaton-myasthenic-syndrome/

  Some people respond well to treatment and find that treatment helps keep their symptoms under control. Others respond less well and find the condition affects their everyday activities and quality of life. LEMS does not affect life expectancy if it’s not associated with cancer. But people with lung cancer and LEMS tend to have a shorter life expectancy because by this point it’s very difficult to treat.

• #1

  https://www.myaware.org/lambert-eaton-myasthenia

  LEMS (Lambert-Eaton Myasthenic Syndrome) is a rare disorder of the nervous system caused by a disruption of how the nerve and muscle talk to each other. […] Unlike myasthenia gravis, LEMS symptoms often start in the limbs. The legs will often feel heavy, a sensation described as walking through treacle. It can also affect the arms and is a lot less common for it to affect the facial muscles. Some people may also find that they experience problems with automatic bodily functions, dry mouth, constipation and impotence in men. […] Symptoms usually start to improve 2-4 weeks after treatment is started. Maximum benefit is usually seen after 6-12 months of treatment.

• #1 Lambert-Eaton Myasthenic Syndrome Versus Myasthenia GravisShare to Facebookprint pageBookmark for latercommentcaret iconcaret iconmore actionsFollow us on facebookFollow us on instagramFollow us on facebookFollow us on linkedincaret icon

  https://myasthenia-gravis.com/clinical/lems-symptom-differences

  A big difference between MG and LEMS involves the eyes. Eye muscle weakness in LEMS is usually milder. It is never the first or only symptom of LEMS. Eye weakness is the first symptom for 3 out of 5 people with MG. And it is the only symptom for 1 out of 4 people with MG. […] In almost everyone with LEMS, muscle weakness starts in the upper legs. It can then affect muscles in the shoulders, hands, feet, and throat. By contrast, muscle weakness starts in the upper legs for only 12 percent of people with MG. Also, severe weakness in the breathing muscles is less common with LEMS than with MG. […] Symptoms of LEMS that are not symptoms of MG include: Transient improvement in strength with exercise/muscle use, Absence of reflexes such as the knee-jerk reaction (areflexia), Return of reflexes after repeated muscle contraction, Dry mouth, Decreased sweating, Erectile dysfunction, Difficulty peeing, constipation.

• #1 Myasthenia Gravis vs. Lambert Eaton Syndrome

  https://www.healthline.com/health/myasthenia-gravis/myasthenia-gravis-vs-lambert-eaton

  Myasthenia gravis and Lambert-Eaton syndrome both cause unusual muscle weakness but in different ways. […] In LEMS, your immune system mistakenly attacks the calcium channels in nerve endings, disrupting the release of specialized messenger molecules called neurotransmitters that trigger muscle contraction. As a result, your muscles cant tighten (contract) properly. […] If you have LEMS, your muscle weakness can temporarily improve with repeated activity or when you repeatedly use a specific muscle. But in people with MG, muscle weakness usually worsens with exercise or when you repeatedly use a specific muscle. […] In addition, LEMS usually begins with weakness in the legs, which may cause difficulty walking. On the other hand, initial MG symptoms typically affect the eye muscles, which can cause eyelid drooping and vision problems, such as double vision. […] LEMS typically responds well to treatment, but your outlook may depend on whether you have an underlying cancer, such as SCLC. People with LEMS who dont have cancer usually have an average life expectancy.

• #1 Lambert-Eaton Myasthenic Syndrome (LEMS): Signs, Symptoms, and Treatment Options — BioMatrix Specialty Infusion Pharmacy

  https://www.biomatrixsprx.com/news/lambert-eaton-myasthenic-syndrome-lems-signs-symptoms-and-treatment-options

  Its important to note that because of similar symptoms of muscle weakness, LEMS is often misdiagnosed as Myasthenia gravis (MG). However key differences are in the severity and type of muscle weakness. For example, eye weakness tends to be milder in LEMS patients and unlike MG, is typically not the only symptom. Severe respiratory muscle weakness found in MG is also rare for people with LEMS.

• #1 New Lambert-Eaton myasthenic syndrome (LEMS) treatments 2025 | Everyone.org

  https://everyone.org/explore/treatment/?id=61

  Although proximal muscles are predominantly affected, distal muscles such as those in the hands and fingers can also become weak. […] While LEMS primarily affects motor function, some patients may report mild sensory disturbances, such as tingling or numbness in the extremities. […] Although uncommon, some patients with LEMS may experience cognitive difficulties, including problems with memory, concentration, or attention. […] Patients may experience sleep disturbances, including difficulty falling asleep or staying asleep, restless sleep, or excessive daytime sleepiness.

• #1 Lambert Eaton Myasthenic Syndrome (LEMS) – Rare Awareness Rare Education

  https://rareportal.org.au/rare-disease/lambert-eaton-myasthenic-syndrome-lems/

  Lambert Eaton myasthenic syndrome (LEMS) is an autoimmune, neuromuscular condition affecting the neuromuscular junction (NMJ). In LEMS, the voltage-gate calcium channels (VGCC) at the NMJ do not function properly and this affects the release of signals (neurotransmitters) that allow the nerve and muscle cells to communicate with each other. LEMS affects voluntary muscles (muscles that can be controlled) as well as the autonomic nervous system (organs that control automatic body functions). This leads to muscle weakness, usually in the legs and arms but can also affect the facial muscles, as well as dry mouth and eyes, constipation, decreased tendon reflexes and other symptoms. […] […] The most common symptom of Lambert Eaton Myasthenic Syndrome (LEMS) is weakness in the proximal muscles (muscles closest to the core of the body), particularly of the legs and arms. Other symptoms include muscle pain and stiffness, double vision and slurred speech. The autonomic nervous system can also be affected, which may lead to dry mouth and eyes, constipation, changes in sweating, drop in blood pressure when moving from sitting or lying down to standing up (orthostatic hypotension) and erectile dysfunction in males. Decreased or absent tendon reflexes may also be observed. There may also be further complications such as gum disease (due to chronic dry mouth) and eye issues including corneal scarring (due to severe dry eyes). Respiratory failure has been reported but is rare in LEMS individuals. […] […] A proportion of individuals with LEMS have also been found to have cancer, such as small cell lung cancer (SCLC). Additional complications of LEMS may include cerebellar ataxia, a disorder of the nervous system that may result in impaired motor skills and coordination.

• #1 Lambert-Eaton myasthenic syndrome (LEMS): Causes, symptoms, and more

  https://www.medicalnewstoday.com/articles/lambert-eaton-syndrome

  The outlook for LEMS varies depending on the underlying cause and effectiveness of treatment. With appropriate management, many people experience significant improvement in symptoms. […] While there is no cure, effective treatments can significantly improve quality of life. Early detection and a multidisciplinary approach are key to managing LEMS effectively.

• #2 Lambert-Eaton myasthenic syndrome: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000710.htm

  Lambert-Eaton myasthenic syndrome (LEMS) is a rare disorder in which faulty communication between nerves and muscles leads to muscle weakness. […] Weakness or loss of movement that can be more or less severe, including: Difficulty climbing stairs, walking, or lifting things, Muscle pain, Drooping of the head, The need to use the hands to get up from a sitting or lying position, Problems talking, Problems chewing or swallowing, which may include gagging or choking, Vision changes, such as blurry vision, double vision, and problem keeping a steady gaze. […] Weakness is generally mild in LEMS. Leg muscles are mostly affected. Weakness may improve after exercise, but continuous exertion causes fatigue in some cases. […] Symptoms related to the other parts of the nervous system often occur, and may include: Blood pressure changes, Dizziness upon standing, Dry mouth, Erectile dysfunction, Dry eyes, Constipation, Decreased sweating.

• #2 Diagnosis and Treatment of Lambert-Eaton Myasthenic Syndrome

  https://practicalneurology.com/articles/2024-apr/diagnosis-and-treatment-of-lambert-eaton-myasthenic-syndrome

  Lambert-Eaton myasthenic syndrome (LEMS) is a rare autoimmune presynaptic disorder of the neuromuscular junction (NMJ) associated with weakness, reduced or absent muscle stretch reflexes, and autonomic dysfunction. […] The primary clinical presentation of LEMS is the triad of muscle weakness, reduced or absent reflexes, and autonomic dysfunction. Weakness is most prominent in the proximal legs and arms, with other muscle groups being less severely affected. […] Muscle weakness in LEMS starts in the proximal limbs, particularly the lower extremities and spreads from proximal to distal muscles. […] Prognosis varies depending upon the underlying cause. Individuals with nontumor-associated LEMS have a normal life expectancy but experience chronic symptoms that impair functional abilities and affect quality of life.

• #2 Lambert-Eaton Disease: Symptoms, Causes and Treatment

  https://lonestarneurology.net/blog/lambert-eaton-disease/

  Lambert-Eaton myasthenic syndrome (LEMS) is a rare autoimmune disorder affecting signals transmitted from the nerves to the muscles. The syndrome is characterized by variable muscle weakness and autonomic nervous system dysfunction, meaning that the muscles cannot contract properly, leading to muscle weakness and other symptoms often associated with small cell lung cancer (SCLC). […] Symptoms may include: […] – dry mouth; […] – excessive fatigue and muscle weakness; […] – soreness in the upper arms and thighs; […] – leg weakness and instability of movement; […] – a paralytic duck-like walk; […] – reduced tendon reflexes; […] – drooping eyelids; […] – erectile dysfunction may occur in men. […] When examining patients with Lambert-Eaton disease, the majority (90%) have antibodies to calcium channels, which consist in the structure of motor nerve fiber endings and tumor cells. The autoimmune attack targets the presynaptic membrane of the neuromuscular synapse. Its disruption results in a decrease in the release of the neuromuscular transmission mediator acetylcholine, which disrupts the passage of excitation from the nerve fiber to the muscle. This process manifests in the body the main symptoms of the syndrome: excessive fatigue and muscle weakness.

• #2 Lambert-Eaton Myasthenic Syndrome Versus Myasthenia GravisShare to Facebookprint pageBookmark for latercommentcaret iconcaret iconmore actionsFollow us on facebookFollow us on instagramFollow us on facebookFollow us on linkedincaret icon

  https://myasthenia-gravis.com/clinical/lems-symptom-differences

  A big difference between MG and LEMS involves the eyes. Eye muscle weakness in LEMS is usually milder. It is never the first or only symptom of LEMS. Eye weakness is the first symptom for 3 out of 5 people with MG. And it is the only symptom for 1 out of 4 people with MG. […] In almost everyone with LEMS, muscle weakness starts in the upper legs. It can then affect muscles in the shoulders, hands, feet, and throat. By contrast, muscle weakness starts in the upper legs for only 12 percent of people with MG. Also, severe weakness in the breathing muscles is less common with LEMS than with MG. […] Symptoms of LEMS that are not symptoms of MG include: Transient improvement in strength with exercise/muscle use, Absence of reflexes such as the knee-jerk reaction (areflexia), Return of reflexes after repeated muscle contraction, Dry mouth, Decreased sweating, Erectile dysfunction, Difficulty peeing, constipation.

• #2 Lambert-Eaton Disease: Symptoms, Causes and Treatment

  https://lonestarneurology.net/blog/lambert-eaton-disease/

  As the myasthenic disease progresses, you will also experience: […] – When the patient is interviewed, they complain of leg weakness and instability of movement, which is more pronounced when walking and climbing stairs for long periods of time; […] – Patients with Lambert-Eaton disease tend to have a paralytic duck-like walk; […] – Tendon reflexes are reduced; […] – Lambert-Eaton syndrome has a definite increase in muscle strength during movement, which distinguishes it from myasthenia gravis, where muscle weakness increases with movement. […] Accompanying symptoms may also include: […] – discomfort in the back and neck; […] – paresthesias in the distal limbs; […] – myalgia; […] – decreased vision acuity; […] – various autonomic disorders, such as decreased lacrimation, dry mouth, orthostatic arterial hypotension, and distal hyperhidrosis. […] In some cases, upper eyelid drooping is found. Rarely impaired swallowing, double vision, and myasthenia gravis movement disorders have been noticed. […] The Lambert Eaton disease can be progressive without proper treatment and care.

• #2 Myasthenia Gravis and Lambert-Eaton Myasthenic Syndrome | NDT

  https://www.dovepress.com/myasthenia-gravis-and-lambert-eaton-myasthenic-syndrome-new-developmen-peer-reviewed-fulltext-article-NDT

  The examination reveals weakness that on manual muscle strength testing often seems disproportionally mild compared with the patients severity of symptomatology. In addition to proximal weakness and mild cranial findings the LEMS patients are typically areflexic. Absent or markedly hypoactive muscle stretch reflexes are normal for patients with LEMS but never seen in patients with myasthenia gravis (in which the reflexes are normal). Absent muscle stretch reflexes in a patient with proximal weakness often leads to a diagnostic question of motor neuropathy such as chronic inflammatory neuropathy which is another reason that many patients can initially be misdiagnosed with other more common neuromuscular conditions. Patients may experience or display on examination an improvement in strength and function with continuous muscle stimulation or exercise. The main presenting symptoms in patients with LEMS are typically proximal lower extremity weakness, difficulty rising from a chair and limitations in walking. In addition, about 50% of patients have evidence for bulbar involvement and half describe ocular symptoms of ptosis or diplopia. Physical examination of sustained grip strength demonstrates a gradual improvement in strength during the first 2-3 seconds of squeezing the hand (referred to as Lambert’s sign).

• #2 Neuro-Ophthalmic Manifestations of Lambert-Eaton Myasthenic Syndrome – EyeWiki

  https://eyewiki.org/Neuro-Ophthalmic_Manifestations_of_Lambert-Eaton_Myasthenic_Syndrome

  Autonomic disturbances, especially anticholinergic, are seen in 80-96% of LEMS patients. In one study, dry mouth was the most frequent complaint found in 75% of patients. Other disturbances included erectile dysfunction, constipation, dry eyes, orthostatic hypotension, anhidrosis, and urinary retention. […] Ocular and bulbar symptoms are reported in 49-78% of LEMS and are usually seen late in the disease as it progresses craniocaudal. Compared to MG, the ocular and bulbar weakness seen in LEMS is typically milder and potentially under-appreciated. […] A Mayo Clinic retrospective review of 167 patients described the ophthalmic symptoms of LEMS including: ptosis (26%), diplopia (20.5%), decreased vision (14%), and dry eye (7%). Ocular signs included ptosis (26%), abnormal ocular motility (8.5%), strabismus (8%), pupillary dysfunction (7%), and dry eyes (2%).

• #2 Lambert-Eaton Myasthenic Syndrome (LEMS) Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/1170810-clinical

  Most patients have a dry mouth, which frequently precedes other symptoms of LEMS. (Many do not mention this unless specifically questioned.) Many patients report an unpleasant metallic taste. Some patients have other manifestations of autonomic dysfunction, including impotence in males and postural hypotension. […] In Lambert-Eaton myasthenic syndrome (LEMS), strength is usually reduced in proximal muscles of the legs and arms, producing a waddling gait and difficulty elevating the arms. The degree of weakness is usually mild, compared with that reported by the patient. […] Some degree of eyelid ptosis or diplopia, usually mild, is found in 25% of patients. Occasionally, difficulty chewing, dysphagia, or dysarthria is present. […] In some patients, strength may improve after exercise and then weaken as activity is sustained. This phenomenon is demonstrable in approximately half of all patients with LEMS.

• #2 Lambert-Eaton Myasthenic Syndrome (LEMS) Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/1170810-clinical

  Symptoms of Lambert-Eaton myasthenic syndrome (LEMS) usually begin insidiously and progress slowly. Many patients have symptoms for months or years before the diagnosis is made. Weakness is the major symptom. Weak muscles may ache and are occasionally tender. Proximal muscles are more affected than distal muscles; lower extremity muscles are affected predominantly. Patients typically have difficulty rising from a chair, climbing stairs, and walking. […] Increased temperatures from fever or the environment may worsen the weakness. Patients may experience transient worsening after hot baths and showers or during systemic illnesses. […] The oropharyngeal and ocular muscles are mildly affected in about one quarter of cases of LEMS, with symptoms that may include ptosis, diplopia, and dysarthria, but they are usually not affected to the same extent or severity as in myasthenia gravis (MG).

• #2 Lambert-Eaton myasthenic syndrome (LEMS) – NYSORA

  https://www.nysora.com/anesthesia/lambert-eaton-myasthenic-syndrome/

  Lambert-Eaton myasthenic syndrome (LEMS) is a very rare condition in which the immune system attacks the neuromuscular junctions thereby interfering with the ability of nerve cells to send signals to muscle cells. […] A miscommunication between the nerve cell and the muscles that leads to the gradual onset of muscle weakness and autonomic nervous system dysfunction. […] Primary clinical manifestation: muscle weakness and muscle fatigue. […] Symptoms develop gradually over weeks or months. […] Lambert-Eaton myasthenic syndrome typically affects upper leg muscle strength first, followed by shoulder muscles, muscles of the hands and feet, muscles affecting speech and swallowing, and eye muscles. […] Dyspnea and respiratory failure. […] Dysarthria and dysphagia are late-stage symptoms.

• #2 Lambert-Eaton Myasthenic Syndrome (LEMS): Symptoms & Causes

  https://my.clevelandclinic.org/health/diseases/23202-lambert-eaton-myasthenic-syndrome-lems

  Lambert-Eaton myasthenic syndrome symptoms include: […] Muscle weakness is a common symptom. […] This weakness usually begins in your upper legs, but can come to involve other muscle groups in your arms, as well as muscles involved in breathing, swallowing and speech. […] Symptoms of LEMS can begin many months or years before the cancer develops or is diagnosed. […] Lambert-Eaton myasthenic syndrome typically affects leg muscle strength (upper leg) first, followed by shoulder muscles, muscles of your hands and feet, muscles affecting your speech and swallowing, and eye muscles. […] Symptoms usually develop slowly over weeks to many months. Symptoms develop more quickly if you have cancer and LEMS. […] Trouble speaking (dysarthria) and trouble swallowing (dysphagia). These are late-stage symptoms. […] Trouble breathing (dyspnea) and respiratory failure. This is an uncommon, late-stage symptom.

• #2 Lambert-Eaton Myasthenic Syndrome – Samir P. Macwan, MD

  https://socalmusclenerve.com/lambert-eaton-myasthenic-syndrome/

  Lambert-Eaton myasthenic syndrome (LEMS) is a rare autoimmune disorder of the neuromuscular junction. It is a miscommunication between the nerve cell and the muscles that lead to the gradual onset of muscle weakness. It starts in the proximal muscles of the legs or arms. […] LEMS is characterized by weakness and fatigue especially of the muscles in the legs and arms. The disease may affect the patients ability to engage in strenuous exercise and may make such activities as climbing stairs or walking up a steep walkway difficult. Onset is gradual, typically taking place over several weeks to many months. There is often a progression of symptoms whereby the shoulder muscles, muscles of the feet hands, speech swallowing muscles and eye muscles are affected in a stepwise fashion. The symptoms progress more quickly when LEMS is associated with cancer. Most LEMS patients also exhibit the following symptoms (sometimes called autonomic symptoms): dry mouth, dry eyes, constipation, impotence, and decreased sweating. LEMS patients with or without cancer may also undergo significant weight loss. The tendon reflexes are diminished or absent on examination. Hence, in summary, LEMS is often described as a clinical triad of proximal muscle weakness, autonomic symptoms and reduced tendon reflexes.

• #2 Lambert-Eaton Myasthenic Syndrome (LEMS): Treatment and more

  https://www.verywellhealth.com/lambert-eaton-myasthenic-syndrome-lems-5100988

  Some people with LEMS also have symptoms related to their eyes. These might include drooping eyelids or double vision. […] LEMS also sometimes causes difficulty swallowing or speaking. However, these symptoms tend to be mild and temporary, if present. […] On medical exam, people with LEMS often dont have normal reflexes (the kind your healthcare provider might check by tapping your knee). […] In people who have LEMS from underlying small-cell lung cancer, symptoms of LEMS usually occur before any symptoms from the lung cancer. […] On average, symptoms may progress more rapidly when someone has LEMS from small-cell lung cancer compared to idiopathic LEMS. […] People who have LEMS without an underlying cancer do not seem to have a shortened life span. However, you might still have some physical limitations, even after youve explored all your treatment options. […] Though you might have some residual symptoms, these seem to plateau with treatment and time in most people.

• #2 Lambert-Eaton Syndrome

  http://library.oumedicine.com/Search/134,25

  Weak muscles (weakness is often relieved for a short time after exercise or exertion) […] Trouble walking, climbing stairs or getting up from a chair […] Tingling sensation in the hands or feet […] Eyelid drooping […] Fatigue […] Dry mouth or dry eyes […] Trouble speaking and swallowing […] Trouble breathing […] Bladder and bowel changes […] Erectile dysfunction […] Decreased sweating […] Weight loss […] Symptoms of Lambert-Eaton Syndrome may become worse when you’re warm or have a fever. As a result, don’t take hot showers or baths. Contact your healthcare provider if you start developing signs of a cold or the flu. Exercising on a regular basis and getting enough sleep may also help you manage your symptoms. […] Common symptoms are weak muscles, trouble walking, tingling sensations, fatigue, and dry mouth.

• #2 Lambert-Eaton myasthenic syndrome – WikEM

  https://wikem.org/wiki/Lambert-Eaton_myasthenic_syndrome

  Often presents with alteration in gait or difficulty rising from a chair. […] Fluctuating symmetric weakness and fatigue, especially of proximal leg muscles. […] Improvement in strength with sustained or repeated exercise (in contrast to MG). […] Muscle stiffness (especially in hip and shoulders). […] Compared with myasthenia gravis, LEMS begins with lower extremities weakness and rarely begins with extraocular muscle weakness. […] Respiratory failure can occur in late stages of the disease. […] Paraneoplastic and autoimmune form of LEMS have similar signs and symptoms.

• #2 Long-term disease history, clinical symptoms, health status, and healthcare utilization in patients suffering from Lambert Eaton myasthenic syndrome: Results of a patient interview survey in Germany – PubMed

  https://pubmed.ncbi.nlm.nih.gov/22352885/

  Twelve patients participated; mean age 66.7 9.8 years. First symptoms occurred at age 52.5 14.0 years. Mean time between first symptoms and diagnosis was 4.4 6.2 years. Patients reported neuromuscular, cranial, and autonomic symptoms plus general fatigue. Two-thirds of patients reported 10 or more symptoms. The most frequent symptoms were leg weakness (91.7%) and general fatigue (83.3%). Restrictions in ADL were reported always or often in 75% of patients. Over half of the patients (n = 7) reported poor or very poor health status. […] LEMS patients report long individual disease histories. Most patients suffer multiple symptoms which are frequently severe and troublesome, and almost all are restricted in ADL with poor health status. There is high utilization of healthcare resources from diagnosis to ongoing treatment.

• #2

  https://link.springer.com/article/10.1007/s00415-024-12206-6

  Lambert-Eaton myasthenic syndrome (LEMS) is an autoimmune-mediated neuromuscular disorder leading to muscle weakness, autonomic dysregulation and hyporeflexia. […] Symptoms include muscle fatigability and proximally pronounced weakness, hypo- or areflexia and autonomous dysregulation. […] LEMS participants showed lower levels of physical functioning (SF-36 mean 34.2 SD 28.6) compared to genP (mean 78.6 SD 21.1) and MG patients (mean 61.3 SD 31.8). […] LEMS patients showed lower mental health sub-scores compared to genP (SF-36 mean 62.7 SD 20.2, vs. 75.7 SD 15.1) and MG patients (SF-36 mean 62.7 SD 20.2, vs. 66.0 SD 18.). […] Depression, anxiety and fatigue were prevalent. […] Most LEMS patients reach maximum disease severity before or within the first year of diagnosis. […] Functional impairment typically improves within 1 year after diagnosis for both autoimmune LEMS (aiLEMS) and pLEMS patients, though pLEMS patients report higher levels of functional impairment throughout the disease course.

• #2 Neuro-Ophthalmic Manifestations of Lambert-Eaton Myasthenic Syndrome – EyeWiki

  https://eyewiki.org/Neuro-Ophthalmic_Manifestations_of_Lambert-Eaton_Myasthenic_Syndrome

  The prognosis of LEMS is dependent on the presence of cancer versus autoimmune disease and the distribution of the weakness. SCLC is an aggressive disease and is often the cause of death in SCLC-LEMS patients. However, the presence of LEMS in SCLC is associated with a longer overall survival independent of other prognostic variables. The prognosis of NT-LEMS varies depending on presentation and response to treatment. Unlike SCLC-LEMS, NT-LEMS does not seem to reduce lifespan.

• #2 Orphanet: Lambert-Eaton myasthenic syndrome

  https://www.orpha.net/en/disease/detail/43393

  Lambert-Eaton myasthenic syndrome (LEMS) is an autoimmune, presynaptic disorder of neuromuscular transmission characterized by fluctuating muscle weakness and autonomic dysfunction frequently associated with small-cell lung cancer (SCLC). […] LEMS is characterized by the clinical triad of proximal muscle weakness, autonomic disturbance, and depressed tendon reflexes. […] The age of onset is typically over 40 years old, although it may occur at any age. […] Tumors, mostly SCLC, are present in fifty to sixty percent of LEMS patients. […] In general, LEMS responds well to symptomatic and immunosuppressive treatments. However, LEMS can affect every day activities and quality of life of individual patients. Life expectancy depends on the presence of lung cancer. Without cancer, the life expectancy is considered normal. As SCLC is a very aggressive cancer, prognosis of patients with LEMS and SCLC is often rather poor. Median survival is 17-24 months, although the amount of patients with long-standing remission or cured is approximately 20%.

• #2

  https://111.wales.nhs.uk/lamberteatonmyasthenicsyndrome/

  Lambert-Eaton myasthenic syndrome (LEMS) is a rare condition that affects the signals sent from the nerves to the muscles. It means the muscles are unable to tighten (contract) properly, resulting in muscle weakness and a range of other symptoms. […] The symptoms of LEMS develop gradually over weeks or months. The main symptoms are weakness in the legs, arms, neck and face, as well as problems with automatic body functions, such as controlling blood pressure. Common symptoms include: aching muscles, feeling very tired all the time (fatigue), difficulty walking and climbing stairs, difficulty lifting objects or raising the arms, drooping eyelids, dry eyes and blurred vision, swallowing problems, dizziness upon standing, a dry mouth, constipation, erectile dysfunction, muscle weakness that gets worse with time. […] There’s currently no cure for LEMS, but a number of treatments can help reduce the symptoms. Some people respond well to treatment and find that treatment helps keep their symptoms under control. Others respond less well and find the condition affects their everyday activities and quality of life.

• #2 Myasthenia Gravis vs. Lambert Eaton Syndrome

  https://www.healthline.com/health/myasthenia-gravis/myasthenia-gravis-vs-lambert-eaton

  Myasthenia gravis and Lambert-Eaton syndrome both cause unusual muscle weakness but in different ways. […] In LEMS, your immune system mistakenly attacks the calcium channels in nerve endings, disrupting the release of specialized messenger molecules called neurotransmitters that trigger muscle contraction. As a result, your muscles cant tighten (contract) properly. […] If you have LEMS, your muscle weakness can temporarily improve with repeated activity or when you repeatedly use a specific muscle. But in people with MG, muscle weakness usually worsens with exercise or when you repeatedly use a specific muscle. […] In addition, LEMS usually begins with weakness in the legs, which may cause difficulty walking. On the other hand, initial MG symptoms typically affect the eye muscles, which can cause eyelid drooping and vision problems, such as double vision. […] LEMS typically responds well to treatment, but your outlook may depend on whether you have an underlying cancer, such as SCLC. People with LEMS who dont have cancer usually have an average life expectancy.

• #2

  https://step1.medbullets.com/neurology/106022/lambert-eaton-syndrome

  A 40-year-old man presents with increasing muscle weakness. He reports difficulty rising from seated position and difficulty climbing stairs. […] Symptoms/physical exam include proximal muscle weakness, difficulty rising from a chair, and difficulty climbing stairs. […] Autonomic symptoms include dry mouth and impotence. […] Symptoms improve temporarily with muscle use (vs myasthenia gravis, where symptoms worsen with muscle use). […] LES does not affect respiratory system as significantly as myasthenia gravis does.

• #3 Neuro-Ophthalmic Manifestations of Lambert-Eaton Myasthenic Syndrome – EyeWiki

  https://eyewiki.org/Neuro-Ophthalmic_Manifestations_of_Lambert-Eaton_Myasthenic_Syndrome

  Lambert-Eaton myasthenic syndrome (LEMS) is a neuromuscular junction disorder characterized by presynaptic autoantibodies against voltage-gated calcium channels (VGCCs) and limb weakness that improves after repetitive voluntary muscle movement. LEMS typically presents with hyporeflexia, autonomic dysfunction, and extremity weakness that progresses caudal to cranial and proximal to distal. […] Extremity weakness is the most common complaint and typically presents as symmetric extremity weakness that fluctuates during the day and worsens with warmth. Weakness in the legs is more common than in the arms and leads to difficulty rising from a seated position or climbing stairs. LEMS classically progresses over weeks to months from proximal to distal and caudal to cranial, eventually developing oculobulbar weakness.

• #3 Understanding Lambert-Eaton Syndrome: A Rare Disorder – AmeriPharma® Specialty Care

  https://ameripharmaspecialty.com/other-health-conditions/understanding-lambert-eaton-syndrome-a-rare-disorder/

  Lambert-Eaton syndrome (LEMS) is a rare disorder that occurs as a result of an immune system attack on the neuromuscular junction (a point where nerves send signals to your muscles). The damage at the neuromuscular junction causes impaired nerve signal transmission to the muscles, which results in gradual muscle weakness and a range of other symptoms. […] This condition is often referred to as Lambert-Eaton myasthenic syndrome due to the similarities of its symptoms to myasthenia gravis (a type of neuromuscular junction disorder). […] The onset of LEMS symptoms is gradual and usually develops over weeks or months. However, in the case of patients with small cell lung cancer, the progression of the LEMS symptoms could be rapid. […] The common symptom of LEMS is proximal muscle weakness, and the distribution of the muscle weakness begins from the lower limbs (upper legs and hips) and moves upward to the shoulder muscles.

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