Department of Neurology, National Hospital Organization Hyogo-Chuo National Hospital, Japan.
Department of Neurology, Kobe City Medical Center General Hospital, Japan.
Intern Med. 2022 Apr 1;61(7):1063-1065. doi: 10.2169/internalmedicine.7902-21. Epub 2021 Sep 18.
We herein report two P/Q-type voltage-gated calcium channel (VGCC) antibody-positive Lambert-Eaton myasthenic syndrome (LEMS) patients who responded dramatically to cholinesterase inhibitors. Patient 1, a 76-year-old man, had small-cell lung cancer and developed LEMS during chemotherapy. When symptomatic treatment was started with pyridostigmine, gait disturbance was ameliorated, and his modified Rankin scale decreased from 4 points to 3 points. Patient 2, a 68-year-old man, had cancer-free LEMS. Distigmine bromide was very effective and ameliorated not only his gait disturbance but also autonomic symptoms, and his modified Rankin scale decreased from 2 points to 1 point. Cholinesterase inhibitors alone may be effective in a small portion of LEMS patients.
我们在此报告两名 P/Q 型电压门控钙通道 (VGCC) 抗体阳性的 Lambert-Eaton 肌无力综合征 (LEMS) 患者，他们对胆碱酯酶抑制剂反应明显。患者 1 为 76 岁男性，患有小细胞肺癌，并在化疗期间发生 LEMS。当开始用吡啶斯的明进行对症治疗时，步态障碍得到改善，改良 Rankin 量表评分从 4 分降至 3 分。患者 2 为 68 岁男性，患有无癌性 LEMS。溴化二氢加兰他敏非常有效，不仅改善了他的步态障碍，还改善了自主症状，改良 Rankin 量表评分从 2 分降至 1 分。胆碱酯酶抑制剂单独治疗可能对一小部分 LEMS 患者有效。
