8例以复视为首发症状的Lambert-Eaton肌无力综合征分析

目的 探讨以复视为首发症状的Lambert—Eaton肌无力综合征（LEMS）的临床特点。方法 回顾性分析8例以复视为首发症状的LEMS患者的发病特点、临床表现及辅助检查。结果 8例患者均为中老年人，以复视为首发症状，部分合并有睑肌无力。所有患者均经胸部CT或X线确诊为肺癌，3例患者经电刺激试验后显示高频重复电刺激波幅升高200％以上，6例（66．6％）手术后病理检查小细胞肺癌。结论 对以复视为首发症状的中老年患者应考虑到Lambert-Eaton肌无力综合征的可能，常规行神经电刺激实验和简单的胸部CT或X线检查，可早期发现肿瘤并采取相应的治疗方案，以免漏诊和误诊。

Analysis on Lambert-Eaton myasthenia syndrome with the primary symptom of diplopia

Objective To discuss the clinical features of Lambert-Eaton myasthenia syndrome(LEMS) with the primary symptom of diplopia.Methods The clinical features,clinical manifestations and assistant examinations of 8 LEMS patients with the primary symptom of diplopia were analyzed retrospectively.Results The 8 patients were all old ones with the primary symptom of diplopia,some of them with ocular myasthenia gravis.All the patients were diagnosed as lung cancer through chest CT or X-ray.There were 3 patients that the amplitude of repeated electrical stimulation in high frequency had been increased over 200% through the experiment of electrical stimulation.6 patients were examined by pathology after the operation that 66.6% had small-cell lung cancer.Conclusions For the elderly patients with the primary symptom of diplopia,the doctors should consider the possibility of Lambert-Eaton myasthenia syndrome.The experiment of routine electrical nerve stimulation and the examination of simple chest CT or X-ray can find the cancer early and let the doctors adopt the corresponding therapy so as not to misdiagnosis and missed diagnosis.