Neurogenic bladder in Lambert-Eaton myasthenic syndrome and its response to 3,4-diaminopyridine.
Autonomic dysfunction, as well as neuromuscular involvement, is a common manifestation of Lambert-Eaton myasthenic syndrome (LEMS). Dry mouth and impotence have been described as typical features of autonomic dysfunction, but neurogenic bladder is infrequent or subclinical in LEMS. We report a patient with neurogenic bladder secondary to LEMS whose condition responded to 3,4-diaminopyridine (3,4-DAP). In this patient's serum, results of repeated measurement with P/Q-type VGCC antibodies proved positive, but not with N-type VGCC and synaptotagmin antibodies. A review of the literature turned up a few patients with voiding dysfunction related to LEMS, but no urodynamic studies were done on these patients. Ours is the first case in which 3,4-DAP was efficacious in treating LEMS and neurogenic bladder. Responses of 3,4-DAP in urodynamic studies suggest that in this LEMS patient neurogenic bladder was caused by defective neurotransmission both in the autonomic detrusor and skeletal abdominal muscles.
Satoh
K
K
First Department of Internal Medicine, Nagasaki University School of Medicine, 1-7-1 Sakamoto, 852-8501, Nagasaki, Japan.
Motomura
M
M
Suzu
H
H
Nakao
Y
Y
Fujimoto
T
T
Fukuda
T
T
Nakane
S
S
Nakamura
T
T
Eguchi
K
K
D015761:4-Aminopyridine / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D000368:Aged; D000077770:Amifampridine; D004576:Electromyography; D005260:Female; D006801:Humans; D015624:Lambert-Eaton Myasthenic Syndrome / Q000150:complications* / Q000652:urine; D001750:Urinary Bladder, Neurogenic / Q000188:drug therapy* / Q000652:urine
D015761:4-Aminopyridine; D000077770:Amifampridine