Isobe Zen, Suga Tatsuo, Katou Toshimitsu, Hara Kenichirou, Aoki Fumiaki, Aoyagi Kana, Ueno Manabu, Maeno Toshitaka, Kurabayashi Masahiko
Department of Respiratory Medicine, Gunma University School of Medicine.
Nihon Kokyuki Gakkai Zasshi. 2008 Mar;46(3):226-31.
A 54-year old man was admitted with general fatigue, muscle weakness and dyspnea on effort. Medical examinations led to a diagnosis of small cell lung carcinoma (SCLC) with Lambert-Eaton myasthenic syndrome (LEMS). Marked improvement of SCLC and symptoms of LEMS were recognized twice during chemoradiotherapy. On his third admission, he showed muscle weakness, dysaethesia, and neurodysfunction of the bladder and rectum. We initially considered these symptoms to be due to spinal metastasis because MRI findings showed multiple spinal metastases. However, electoromyogram and nerve conduction study demonstrated that his muscle weakness resulted from LEMS though dysethesia and neurodysfunction of bladder and rectum were caused by spinal metastasis. We believe that it is important to perform electomyogram and nerve conduction studies, not only radiographic findings, to detect the "hidden" symptoms of LEMS.
一名54岁男性因全身乏力、肌肉无力及活动时呼吸困难入院。医学检查诊断为小细胞肺癌（SCLC）伴兰伯特-伊顿肌无力综合征（LEMS）。在放化疗期间，SCLC及LEMS症状两次出现明显改善。第三次入院时，他出现肌肉无力、感觉异常以及膀胱和直肠神经功能障碍。我们最初认为这些症状是由脊髓转移所致，因为磁共振成像（MRI）结果显示多处脊髓转移。然而，肌电图和神经传导研究表明，他的肌肉无力是由LEMS引起的，而膀胱和直肠的感觉异常及神经功能障碍是由脊髓转移导致的。我们认为，为了检测LEMS的“隐匿”症状，进行肌电图和神经传导研究很重要，而不仅仅依赖影像学检查结果。
