Lambert-Eaton myasthenic syndrome (LEMS) is an autoimmune disease that causes muscle weakness due to faulty nerve cells not releasing enough acetylcholine. Symptoms include difficulty eating, vision problems, and respiratory muscle control issues. Treatment includes plasmapheresis and immunosuppressant drugs. LEMS is similar to myasthenia gravis but muscles appear to strengthen with activity.
Lambert-Eaton myasthenic syndrome (LEMS) is an autoimmune disease involving nerves and muscles that causes significant muscle weakness. It is often associated with certain types of cancer or other autoimmune disorders. It is caused by faulty nerve cells that fail to release sufficient amounts of acetylcholine, the chemical essential for the conduction of impulses between nerves and muscles. There are a number of treatments available for the disorder, but serious complications are possible.
There are a number of symptoms of Lambert-Eaton myasthenic syndrome. Many of these symptoms may be indicative of other ailments, so doctors must investigate all complaints, as well as perform specialized tests, before making the diagnosis. Most of the signs are related to muscle control and voluntary movement. Others are directly related to the muscles themselves.
Some indicators of Lambert-Eaton syndrome are related to nervous system function. Patients may experience dramatic changes in blood pressure, dizziness or fainting. They may notice muscle wasting or decreased reflex actions. For example, the knee reflex may be diminished or completely absent. Significant muscle weakness may be present, although this may improve with exercise.
Many people with LEMS have difficulty eating and drinking. They may have difficulty chewing or swallowing food or eating without choking. A number of vision problems may be present, including blurred vision, an inability to focus, or double vision. Tasks such as going up and down stairs, lifting or carrying objects, and changing positions can be very difficult. Also, some people may find it difficult to hold their head up or speak clearly.
Serious complications of LEMS include difficulty controlling the respiratory muscles and trouble breathing. When swallowing becomes severely impaired, patients may be unable to receive adequate oral nutrition. Because of a reduction in voluntary muscle control, people may be more susceptible to dangerous falls or other accidents. Most patients, however, respond well to medical management of this disorder.
If an autoimmune disease or cancer contributes to a patient’s LEMS, treatment of the disorder will initially focus on controlling the underlying diagnosis. Other treatments for Lambert-Eaton myasthenic syndrome include plasmapheresis, plasmapheresis, and immunosuppressant drugs. In plasma exchange, donated plasma replaces the patient’s plasma to reduce the number of nerve-damaging cells in the body. Plasmapheresis involves separating these harmful protein cells from the patient’s blood outside the body, then pumping the clean blood back inside.
Lambert-Eaton myasthenic syndrome closely mirrors the muscle disorder myasthenia gravis in several ways, primarily in the muscle weakness that occurs with both conditions. The main difference between the two diagnoses is the fact that with LEMS, muscles appear to strengthen for limited periods with activity or exercise. This is because the small amounts of acetylcholine released with each muscle contraction eventually culminate to produce a stronger contraction. In the case of myasthenia gravis, the muscles continue to weaken with each contraction.
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