以共济失调起病的Lambert-Eaton肌无力综合征1例

A case of Lambert-Eaton myasthenia syndrome with the onset of ataxia

Lambert-Eaton肌无力综合征(Lambert-Eaton myasthenic syndrome,LEMS)是一种免疫介导的累及神经肌肉接头疾病,主要表现为肌无力、自主神经功能障碍及腱反射减低。现报告1例LEMS患者,以头晕、共济失调为首发症状,后出现眼睑下垂,重复神经电刺激可见低频递减,高频递增,P/Q型压力门控钙离子通道(voltage-gated calcium channels,VGCC)抗体阳性,胸部CT提示肺结节及肿大纵隔淋巴结,经穿刺活检病理证实为小细胞肺癌。提示神经内科医师,共济失调也是LEMS的重要表现之一,避免漏诊。

Lambert-Eaton myasthenic syndrome(LEMS)is an immune-mediated disorder involving neuromuscular junctions,characterized by muscle weakness,autonomic dysfunction,and reduced tendon reflexes.We report a LEMS case presented initially with dizziness and ataxia,followed by eyelid ptosis.Repetitive nerve stimulation revealed low frequency decreasing and high frequency increasing.P/Q type Voltage-gated calcium channels(VGCC)antibody was positive.Chest CT showed pulmonary nodules and enlarged mediastinal lymph nodes which were pathologically confirmed as small cell lung cancer.Given that ataxia is also an important manifestation of LEMS,the case report intends to increase the awareness of LEMS-related ataxia among neurologists to avoid misdiagnosis.