What are the treatment approach considerations in Lambert-Eaton myasthenic syndrome (LEMS)?

Updated: May 23, 2019
  • Author: David E Stickler, MD; Chief Editor: Nicholas Lorenzo, MD, MHA, CPE  more...
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Answer

Individually tailor therapy for Lambert-Eaton myasthenic syndrome (LEMS) on the basis of severity of weakness, underlying disease(s), life expectancy, and response to previous treatment. Therapy is best coordinated with the primary care physician and appropriate consultants.

If an underlying neoplasm is present (eg, small cell lung cancer [SCLC]), initial treatment should be aimed at the neoplasm because weakness frequently improves with effective cancer therapy. No further LEMS treatment may be necessary in some patients. Typical treatments for patients with SCLC as the cause of their LEMS would include combination therapy with cisplatin and etoposide. Through both tumor modulation and its direct immunosuppressive properties, chemotherapy does seem to improve the symptoms of LEMS.

In patients with LEMS who do not have cancer, aggressive immunotherapy should be considered.


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