Tang Yufeng, Wang Ke, Chen Zhonglun, Zhou Muke, Duan Jingfeng, Liu Tao, Zhou Dong
Department of Neurology, West China Hospital, Sichuan University, Chengdu Department of Neurology Department of Ophthalmology, Mianyang Central Hospital, Mianyang, Sichuan Department of Oncology, The Affiliated Jiangyin Hospital of Southeast University Medical College, Wuxi, Jiangsu, P.R. China.
Medicine (Baltimore). 2017 Jun;96(22):e6484. doi: 10.1097/MD.0000000000006484.
The Lambert-Eaton myasthenic syndrome (LEMS) is a neuromuscular disease; its unique symptoms of LEMS include dry mouth with a metallic taste, constipation, and erectile dysfunction. As it is quite rare, isolated ocular muscle impairment associated with LEMS east to ignore.
A 65-year-old man presented with alternating ptosis and diplopia. Isolated ocular muscle impairment had lasted for 6 years, and the patient was initially diagnosed with ocular myasthenia gravis (MG). Treatment with azathioprine only slightly improved symptoms over the first 2 months; long-term treatment was not effective.
Dynamic observation of chest computed tomography images revealed a slowly progressing nodule in the lower lobe of the left lung. The subsequent pathologic examination following mass resection confirmed a diagnosis of lung adenocarcinoma.
The patient was ultimately diagnosed with the Lambert-Eaton myasthenic syndrome associated with pulmonary adenocarcinoma.
Resection of the lung tumor relieved all symptoms.
Other causes of ocular MG symptoms should be considered when standard MG therapy is ineffective, especially the Lambert-Eaton myasthenic syndrome.
兰伯特-伊顿肌无力综合征（LEMS）是一种神经肌肉疾病；LEMS的独特症状包括口干并伴有金属味、便秘和勃起功能障碍。由于该病相当罕见，与LEMS相关的孤立性眼肌损害容易被忽视。
一名65岁男性出现交替性上睑下垂和复视。孤立性眼肌损害持续了6年，患者最初被诊断为眼肌型重症肌无力（MG）。在最初的2个月里，使用硫唑嘌呤治疗仅使症状稍有改善；长期治疗无效。
胸部计算机断层扫描图像的动态观察显示左肺下叶有一个缓慢进展的结节。肿块切除后的后续病理检查确诊为肺腺癌。
该患者最终被诊断为与肺腺癌相关的兰伯特-伊顿肌无力综合征。
肺部肿瘤切除后所有症状均得到缓解。
当标准的MG治疗无效时，应考虑眼肌型MG症状的其他病因，尤其是兰伯特-伊顿肌无力综合征。
