Lambert Eaton myasthenic syndrome (LEMS): variants

Paraneoplastic cerebellar degeneration with LEMS (PCD-LEMS)

• This is associated with pulmonary and extra-pulmonary small cell cancer
• It manifests as ataxia
• The P/Q-type VGCC antibodies are present in most cases
• GRP78 antibodies also play a role

LEMS-myasthenia gravis overlap syndrome

Genetic LEMS

Acronyms

References

1. Kitanosono H, Motomura M, Tomita H, et al. Paraneoplastic cerebellar degeneration with Lambert-Eaton myasthenic syndrome: a report of an effectively treated case and systematic review of Japanese cases. Brain Nerve 2019; 71:167-174.
2. Zalewski N, Lennon VA, Pittock SJ, Mckeon A. Calcium channel autoimmunity: Cerebellar ataxia and lambert-eaton syndrome coexisting. Muscle Nerve 2017; doi: 10.1002/mus.26053 (Epub ahead of print).
3. McKasson M, Clardy SL, Clawson SA, et al. Voltage-gated calcium channel autoimmune cerebellar degeneration: case and study of cytotoxicity. Neurol Neuroimmunol Neuroinflamm 2016; 3:e222.
4. Shimizu F, Takeshita Y, Sano Y, et al. GRP78 antibodies damage the blood-brain barrier and relate to cerebellar degeneration in Lambert-Eaton myasthenic syndrome. Brain 2019; 142:2253-2264.
5. Takasugi J, Shimamura M, Koda T, et al. Paraneoplastic cerebellar degeneration and Lambert-Eaton Myasthenic Syndrome associated with neuroendocrine carcinoma of the oropharynx. Intern Med 2018; 57:587-590.
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Related checklists

• Lambert Eaton myasthenic syndrome (LEMS): causes
• Lambert Eaton myasthenic syndrome (LEMS): clinical features