title: Lambert-Eaton myasthenic syndrome in mixed small cell carcinoma and adenocarcinoma of extrapulmonary origin.
abstract: A patient with typical Lambert-Eaton myasthenic syndrome (LEMS) has a clinical manifestation of proximal muscle weaknesses, a larger-than-100% incremental change in repetitive nerve stimulation on high-rate stimulation electrophysiological testing, and a paraneoplastic origin from small cell carcinoma of the lung. Here, we present a patient with an atypical myasthenic syndrome with an oculobulbar-predominant muscle involvement, a borderline incremental change in repetitive nerve stimulation at high frequencies, and a paraneoplastic origin from extrapulmonary mixed small cell carcinoma and adenocarcinoma. The purpose of this report is to emphasize the importance of painstaking scrutiny in the examination of a patient with a less-common presentation of LEMS.
authors.affiliation: Department of Neurology, Shin-Kong WHS Memorial Hospital, 95 Wen-Chang Road, Shin-Lin District, Taipei, Taiwan.
authors.forename: Anna
authors.initials: A
authors.lastname: Chang
authors.forename: Han-Cheng
authors.initials: HC
authors.lastname: Wang
authors.forename: Wei-Chih
authors.initials: WC
authors.lastname: Hsu
mesh_terms: D000230:Adenocarcinoma / Q000150:complications* / Q000473:pathology; D000368:Aged; D002245:Carbon Dioxide / Q000378:metabolism; D018288:Carcinoma, Small Cell / Q000150:complications* / Q000473:pathology; D004558:Electric Stimulation; D006801:Humans; D015624:Lambert-Eaton Myasthenic Syndrome / Q000150:complications* / Q000473:pathology; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D018908:Muscle Weakness / Q000209:etiology; D009460:Neurologic Examination; D010257:Paraneoplastic Syndromes / Q000473:pathology; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed
chemical_list: D002245:Carbon Dioxide