Lambert-Eaton Myasthenic Syndrome: A Very Rare and Tortuously Exasperating Facet of Pre-Synaptic Disorder of Neuromuscular Junction

Lambert-Eaton Myasthenic Syndrome (LEMS) is a very rare and unusual autoimmune disorder of Neuromuscular Junction (NMJ) that is associated with impaired neuromuscular transmission due to loss of voltage-gated calcium channel (VGCC) present on the pre-synaptic nerve terminal. Of all the different proteins like synaptotagmin that are attacked by auto-antibodies, P/Q-type of VGCC is found to be targeted in 90 % of patients. The influx of calcium through VGCC is important for exocytosis of synaptic vesicles. LEMS is a clinical "triad" of proximal muscle weakness, areflexia, and autonomic dysfunctions. Half of the LEMS patients are almost always associated with the small-cell lung carcinoma (SCLC), the knowledge of which has led to the finding of different paraneoplastic, and non-tumor rela...

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