Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan.
Department of Animal Model Development, Brain Research Institute, Niigata University, Japan.
Intern Med. 2024 May 1;63(9):1295-1300. doi: 10.2169/internalmedicine.2569-23. Epub 2023 Sep 22.
A 74-year-old man experienced diplopia, generalized muscle weakness, and acute respiratory failure. He was diagnosed with Lambert-Eaton myasthenic syndrome (LEMS) and treated with immunotherapy, but no improvement was observed, and additional symptoms, including central apnea and hallucinations, appeared. Subsequent serum and cerebrospinal fluid (CSF) analyses confirmed the presence of GABA receptor antibodies, indicating the coexistence of autoimmune encephalitis. Although there were no findings of malignancy, it is highly likely that occult small-cell lung carcinoma was present. When atypical symptoms occur in patients with LEMS, it is important to consider the possibility of concomitant autoimmune encephalitis.
一位 74 岁男性出现复视、全身肌肉无力和急性呼吸衰竭。他被诊断为 Lambert-Eaton 肌无力综合征(LEMS),并接受免疫治疗,但未见改善,且出现其他症状,包括中枢性呼吸暂停和幻觉。随后的血清和脑脊液(CSF)分析证实存在 GABA 受体抗体,表明同时存在自身免疫性脑炎。虽然没有发现恶性肿瘤的迹象,但很可能存在隐匿性小细胞肺癌。当 LEMS 患者出现非典型症状时,需高度考虑同时存在自身免疫性脑炎的可能性。