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May 21, 2013; 80 (21) Resident and Fellow Section

Child Neurology: Diagnosis of Lambert-Eaton myasthenic syndrome in children

Bethanie Morgan-Followell, Emily de los Reyes
First published May 20, 2013, DOI: https://doi.org/10.1212/WNL.0b013e318293e14e
Bethanie Morgan-Followell
From the Division of Child Neurology, Nationwide Children's Hospital, The Ohio State University, Columbus.
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Emily de los Reyes
From the Division of Child Neurology, Nationwide Children's Hospital, The Ohio State University, Columbus.
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Child Neurology: Diagnosis of Lambert-Eaton myasthenic syndrome in children
Bethanie Morgan-Followell, Emily de los Reyes
Neurology May 2013, 80 (21) e220-e222; DOI: 10.1212/WNL.0b013e318293e14e

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Abstract

Objective: To report a case of Lambert-Eaton myasthenic syndrome (LEMS) in a child and review the existing literature of LEMS in children.

Methods: We report a pediatric case of LEMS with the classic clinical triad of proximal weakness, autonomic dysfunction, and areflexia; the characteristic increment in compound motor action potential on high-frequency repetitive nerve stimulation; and positive serum P/Q-type voltage-gated calcium channel antibodies. Only 11 pediatric cases of LEMS have been reported in the literature.

Results: The patient's presentation with LEMS led to the diagnosis of occult neuroblastoma. Based on review of the existing pediatric literature, no consistent clinical or electrodiagnostic criteria exist to diagnose LEMS in children.

Conclusions: There exists a need for consistent clinical criteria and electrodiagnostic testing for prompt diagnosis of LEMS in children. Prompt identification of LEMS will alert the physician to search for malignancy or another immune-mediated process.

GLOSSARY

CMAP=
compound motor action potential;
LEMS=
Lambert-Eaton myasthenic syndrome

Footnotes

  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • © 2013 American Academy of Neurology
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