title: Asymptomatic Lambert-Eaton syndrome.
abstract: BACKGROUND
  All descriptions of the Lambert-Eaton syndrome are based on symptomatic patients. We incidentally encountered electromyographic evidence of this syndrome in a patient being studied for another reason. The patient had controlled hypothyroidism and smoked for 9 pack-years but never had symptoms of weakness or had evidence of cancer.
  
  
  METHODS
  Detailed electrophysiological and serological evaluations were undertaken in this study.
  
  
  RESULTS
  Neuromuscular transmission tests were consistent with a presynaptic disorder. Autoantibodies specific for P/Q-type voltage-gated calcium channels (VGCC) were detected in the serum and persisted throughout 7 years of follow-up. Multiple IgG markers of thyrogastric autoimmunity also were detected.
  
  
  CONCLUSIONS
  This demonstration of asymptomatic Lambert-Eaton syndrome persisting for 8 years provided novel insight into the natural history of the disorder. It is plausible that patients with a subclinical syndrome would have abrupt neuromuscular decompensation when challenged with medications that compromise the safety factor for synaptic transmission.
authors.affiliation: Department of Neurosciences, California Pacific Medical Center, San Francisco, California, USA.
authors.forename: Eric H
authors.initials: EH
authors.lastname: Denys
authors.forename: Vanda A
authors.initials: VA
authors.lastname: Lennon
mesh_terms: D058070:Asymptomatic Diseases; D001323:Autoantibodies / Q000276:immunology; D015220:Calcium Channels / Q000276:immunology; D004568:Electrodiagnosis; D004576:Electromyography; D005260:Female; D006801:Humans; D033162:Incidental Findings; D015624:Lambert-Eaton Myasthenic Syndrome / Q000150:complications / Q000175:diagnosis* / Q000276:immunology; D020423:Median Neuropathy / Q000150:complications / Q000175:diagnosis*; D008875:Middle Aged; D009431:Neural Conduction
chemical_list: D001323:Autoantibodies; D015220:Calcium Channels
keywords: Lambert-Eaton syndrome; myasthenic syndrome; organ-specific autoimmunity; pernicious anemia; voltage-gated calcium channels