癌性Lambert-Eaton肌无力综合征四例临床及电生理研究

Carcinomatous Lambert-Eaton Myasthenic Syndrome: Clinical and Electrophysiological Study of 4 Cases

目的研究癌性Lambert－Eaton肌无力综合征（LEMS）临床及电生理特征。方法回顾性地评价了4例病理证实的癌性LEMS（例1、2为小细胞性肺癌，例3为肾上腺癌，例4为乳腺癌）的临床和电生理资料。结果面神经、腋神经及尺神经重复电刺激示，诱发电位起始波幅减小（0．4～0．7mV）；5Hz以下低频刺激后波幅递减16％～54％（对照：小于15％），但在10Hz以上高频刺激后波幅递增120％～657％（对照：小于65％）；例2和例3肌电图和神经传导速度测定示，多发周围神经源性损害，以感觉神经纤维轴索损害为主。结论观察结果表明，部分癌性LEMS患者的神经肌肉接头和周围神经可同时受累。

To study the clinical and electrophysiological characteristics of carcinomatous Lambert--Eaton myasthenic syndrome (LEMS ). Methods Tase 3 with adrenal cancer, and case 4 with breast cancer ) were studied. Results Repeatitive stimulation of the facial, axilliary and/or niner nerve showed diminished amplitude of initial response (0. 4--0. 7 mV); Amplititude of the response at less than 5 Hz stimulation was diminished 16ary and/or niner nerve showed diminished amplitude of initial response (0.4- 0. 7 mV); Amplititude of the response at less than 5 Hz stimulation was diminished 16%-54% (control: less than 15% ) but that at more than 10 Hz stimulation increased 120%-657% (control: less than 65%). EMG and NCV showed multiple peripheral neuropathy with predominant sensory a-conal lesion in the 2nd and 3rd cases. Conclusion Our findings indicated that both the neuromuscular junctions and the peripheral nerves might be involved in some carcinomatous LEMS.