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We evaluated the outcome in 16 patients with Lambert-Eaton myasthenic syndrome(LEMS)associated with histologically verified small-cell carcinoma (SCC).Thirteen patients received specific tumor therapy(chemotherapy, radiation therapy,or resection)and most also received pharmacologic and immunologic treatment for LEMS.Seven of 11 patients surviving for more than 2 months after tumor therapy showed substantial neurologic improvement(1 patient being in complete remission at 7 years);in 3 of 11 improvement was transient.An EMG index of disease severity(compound muscle action potential amplitude in abductor digiti minimi)was significantly increased at final follow-up(p<0.01;n=11).A pretreatment amplitude>3.0 mV was a good prognostic sign.We conclude that a combined treatment approach in SCC-LEMS usually results in neurologic improvement. |
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