Lambert-Eaton myasthenic syndrome - Signs and symptoms

Symptoms usually insidious debut, many patients have symptoms for months or years before diagnosis. Weakness is the major symptom affecting more than proximal muscles of the distal, especially in the legs.
Typical patient with Lambert-Eaton syndrome shows slowly progressive proximal weakness of lower limbs:Powerless-muscle cramps may be painful and occasionally sensitiveEye-muscles and can be easily affected orofaringiali-Respiratory muscles are usually not affected, but cases with severe respiratory compromise were reported.
Most patients have dry mouth, which usually precedes other symptoms.:, Many patients reported an unpleasant metallic taste in mouth-Some patients have other manifestations of autonomic dysfunction including postural hypotension and impotence in men.
The syndrome may be revealed when paralysis occurs after prolonged use of neuromuscular blocking agents during surgery.Exacerbations of weakness has been described after administration of aminoglycosides or fluoroquinolones, antibiotics, magnesium, calcium channel blockers and intravenous iodine contrast agents.The relationship between cancer and Eaton-Lambert syndrome:And old-onset smoking are major risk factors for cancer in patients with PCOS-Duration of symptoms is a risk factor-If not discovered a tumor in the first 2 years after the onset of cancer symptoms is unusual.Physical Exam:Weakness is usually mild-comparable patient complaints-Muscle strength is reduced in the proximal muscles of the legs and arms producing and swinging gait difficulty lifting armsA degree of eyelid ptosis or diplopia is usually mild in 25% of patients found, occasionally difficult chewing, dysphagia or dysarthria present-Most patients have mouth, dry eyes or skinIn some patients, may improve muscle strength after exercise and lose weight if the activity is sustained, this phenomenon is demonstrable in approximately half of patientsTendon reflexes are reduced or absent but can often be caused or enhanced by adequate muscle activation, or repeatedly hitting tendonSensory examination is normal--Tensilonul and pyridostigmine can improve muscle strength, but rarely so dramatically as in myasthenia gravis.