Lambert-Eaton Syndrome Flashcards Preview

Foundations II Exam 4 (Jess) > Lambert-Eaton Syndrome > Flashcards

Flashcards in Lambert-Eaton Syndrome Deck (13):
1

Primary manifestation of Lambert-Eaton Syndrome is what? What is it/what is it a/w?

muscular weakness

autoimmune disorder

50% a/w malignancy (paraneoplastic syndrome)

2

Risk factors of Lambert-Eaton Syndrome

-malignancy
-personal or family hx of autoimmune dz

3

Pathophys of Lambert-Eaton Syndrome

-antibodies bind to voltage gated calcium channels
-interfere w/ calcium influx
-reduced acetylcholine release from presynaptic membrane
-impaired muscle fxn

4

What are the 2 types of LEMS?

Paraneoplastic
non-paraneoplastic

5

MC malignancy a/w Paraneoplastic LEMS?

small cell lung CA

6

Presentation of both types of LEMS?

Slowly progressive symmetric proximal limb/muscle weakness
(-alteration in gait, difficulty arising from chair or managing stairs
-assoc. depressed or absent DTRs)

muscle fatiguability or cramping after prolonged exercise

Post-exercise facilitation

Autonomic dysfunction (dry mouth, ptosis, sluggish pupillary light reflex)

7

How is it differentiated from MG?

Post exercise facilitation
-recovery of DTRs or improvement in muscle strength w/ brief vigorous muscle activation=
Unique to LEMS

(In MG, the more they do the weaker they get)

8

MC autonomic sx a/w LEMS? What other one is important?

dry mouth due to reduced salivation = #1

Sluggish pupillary response

9

What would nerve conduction studies show in LEMS?

100% or more improvement in measurements post-exercise

10

Tx of Paraneoplastic LEMS

tumor resection

11

For patients w/ moderate-severe weakness in LEMS, what do you give?

Pyridostigmine-> ACh-esterase inhibitor

3,4-DAP (3,4-diaminopyridine)--> enhances calcium entry at the presynaptic terminal

12

Pt with mild weakness w/o significant impairment tx?

Nothinnn, just monitor

13

What can you give for immunosuppression in LEMS pts?

Prednisone and azathioprine (DMARD)