Lambert-Eaton肌无力综合征与癌

目的　 Lambert-Eaton肌无力综合征 (LEMS)临床少见。此报告旨在增进人们对这一综合征的认识。方法　对 2 3例 LEMS患者的临床资料做回顾性分析。结果　全组 2 3例 ,伴癌者 1 9例 (83 % ) ,其中小细胞肺癌(SCLC) 1 5例。首发症状以双下肢无力最常见 (5 2 % )。随访期间有颅神经受累 (61 % )、上肢无力 (70 % )、下肢无力 (1 0 0 % )、自主神经症状 (3 0 % )、腱反射减低 (87% )。高频 (2 0～ 5 0 Hz)重复神经电刺激波幅递增 1 0 0 %～71 8% ,平均增 2 82 %。有 1 5例 (79% )肌无力症状早于肺部症状平均 4.5个月。抗肿瘤治疗 1 2例 ,有 8例 LEMS症状显著改善或消失。结论　 LEMS与癌有显著相关倾向 ,尤其与 SCLC更明显。对 40岁以上男性 LEMS患者应积极寻找潜在的恶性肿瘤

The Association of the Lambert-Eaton Myasthenic Syndrome with Carcinoma

Objective To observe the rare Lambert Eaton myasthenic syndrome (LEMS) in association with carcinoma. Methods The clinical material of 23 cases LEMS were reviewed and analysed. Results 19 of 23 cases were associated with carcinoma (83%),15 of which had small cell lung cancer(SCLC).The lower limbs weakness (52%) as initial symptom was the most common, and was followed by cranial nerve symptoms (61%), upper limb weakness (70%), lower limbs weakness (100%) and autonomic symptoms (30%) succesively. When the repetitive nerve stimulation at high rate (20 Hz to 50 Hz) were applied,the average increment in the compound motor action potential amplitude was 282%(range:100% to 718%).Anti tumour treatment for lung cancer in 12,the symptoms of LEMS were improved significantly or disapeared in 8 (67%). Conclusions Our observation has made us inclined to the association of LEMS with carcinoma, especially SCLC. The malignance should actively be searched for in LEMS of male patient above 40 years old.