title: A patient with coexisting myasthenia gravis and lambert-eaton myasthenic syndrome.
abstract: BACKGROUND
  The coexistence of myasthenia gravis (MG) and Lambert-Eaton myasthenic syndrome (LEMS) is very rare and remains controversial.
  
  
  METHODS
  A 48-year-old woman initially presented with noticeable right ptosis and intermittent diplopia. She then developed fluctuating proximal limb weakness and difficulty in swallowing. The serum titer of anti-acetylcholine-receptor antibody was elevated and the edrophonium (Tensilon) test was positive. However, repetitive nerve stimulation revealed abnormalities typical of LEMS. The patient exhibited a good response to treatment with anticholinesterase inhibitors and steroids, and long-term evaluation disclosed that she presented with the clinical, electrophysiological, and immunological characteristics of both diseases.
  
  
  CONCLUSIONS
  The reported clinical and electrophysiological features suggest that this patient was a very rare case of combined MG and LEMS.
authors.affiliation: Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Jee-Ae
authors.initials: JA
authors.lastname: Kim
authors.forename: Young-Min
authors.initials: YM
authors.lastname: Lim
authors.forename: Eun Hye
authors.initials: EH
authors.lastname: Jang
authors.forename: Kwang-Kuk
authors.initials: KK
authors.lastname: Kim
keywords: Lambert-Eaton myasthenic syndrome; myasthenia gravis; overlap syndrome; repetitive nerve stimulation tests