What's the treatment for Lambert-Eaton Myasthenic syndrome? Ongoing Patient Group!

What's the treatment for Lambert-Eaton Myasthenic syndrome?

Please note: I update this page more than all pages and let you know what treatments are tried not only in the U.S.A. But around the world. Some info may look misspelled due to my use of a translation tools from around the world news.

There is no cure for LEMS. Patients over 50 with a history of long-term smoking are most likely to have an associated tumor. The LEMS may vanish if the tumor is curedh 4-diaminopyridine (3, 4-DAP) symptomatic treatment consists of 3. A drug called diaminopyridine (DAP) and immunosuppressants (the steroid prednisone, lEMS has been treated with pyridostigmine bromide (Mestinon) to increase the transmission of acetylcholine across the neuromuscular junction, cyclosporine) azathioprine. As may intravenous immunoglobulin (IVIg) plasma exchange provides improvement in some patients with LEMS. Multiple treatment options are available to improve symptoms and sometimes produce remission however.

without severe respiratory or bulbar weakness:  Plasma exchange or high-dose IVIG may be used to induce relatively rapid but transient improvement in symptoms. Although it is unclear whether scheduled infusions produce sustained improvement small RCTs have demonstrated short-term improvement for IVIG (up to 8 weeks). Although repeated courses may be necessary to sustain improvement observational studies suggest that treatment with plasma exchange may result in short-term improvement. With associated decline in serum voltage-gated calcium-channel antibody titres maximum improvement is noted at 2 to 4 weeks following infusion. Pre-treatment with paracetamol and diphenhydramine should be considered with IVIG.

Options:

 Plasma exchange: 2-3 L plasma volume during each of 5 treatments on alternate days over 2-week period

OR 

paracetamol : 1 g orally administered 30 minutes prior to commencing high-dose IVIG, maximum 4 g/day

and

diphenhydramine : 25-50 mg orally administered 30 minutes prior to commencing high-dose IVIG, maximum 200 mg/day

and

normal immunoglobulin human : 2 g/kg total dose intravenously given over 2-5 days

Therapy is best coordinated with the primary care physician and appropriate consultants. 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. Initial treatment should be aimed at the neoplasm because weakness frequently improves with effective cancer therapy if an underlying neoplasm is present (eg, small cell lung cancer [SCLC]). Life expectancy, individually tailor therapy for Lambert-Eaton myasthenic syndrome (LEMS) on the basis of severity of weakness, underlying disease(s), and response to previous treatment. Aggressive immunotherapy should be considere in patients with LEMS who do not have cancer Chemotherapy does seem to improve the symptoms of LEMS through both tumor modulation and its direct immunosuppressive properties.

Link to an ongoing Patient Group HERE!