Person in sneakers walking with walker

Clinical Presentation of LEMS

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Be LEMS alert

Lambert-Eaton myasthenic syndrome (LEMS) is often suspected based on a triad of symptoms1:

  • Proximal muscle weakness
  • Autonomic dysfunction
  • Areflexia or hyporeflexia

Differential diagnosis of LEMS may be challenging, as its clinical manifestations are often subtle, gradual in onset, or nonspecific. Consequently, LEMS may be misdiagnosed as other neuromuscular disorders, most commonly myasthenia gravis (MG).2

Prompt identification of LEMS symptoms facilitates earlier diagnosis and timely initiation of disease-specific treatment.1,3

Patient talking to healthcare provider

Identify LEMS based on a unique set of signs and symptoms4

Estimated percentages.

Chart showing LEMS signs and symptoms, including autonomic symptoms, neuromuscular symptoms, and tendon reflex symptoms. Autonomic symptoms include dry mouth - 83%; orthostatic hypotension - 29%; constipation - 34%; impotence - 65%. Neuromuscular symptoms include oculobulbar involvement - 51%; proximal arm muscle weakness - 78%; proximal leg muscle weakness - 97%; distal leg muscle weakness - 31%. Tendon reflex symptoms include areflexia/hyporeflexia - 90%

Learn more about ophthalmic signs and symptoms of LEMS.5

A video displaying a patient with LEMS having a waddling gaitWatch video

Watch an example of how LEMS can affect a patient’s gait.

References: 1. Titulaer MJ, Lang B, Verschuuren JJ. Lambert-Eaton myasthenic syndrome: from clinical characteristics to therapeutic strategies. Lancet Neurol. 2011;10(12):1098-1107. 2. Merino-Ramírez MÁ, Bolton CF. Review of the diagnostic challenges of Lambert-Eaton syndrome revealed through three case reports. Can J Neurol Sci. 2016;43(5):635-647. 3. Ivanovski T, Miralles F. Lambert-Eaton myasthenic syndrome: early diagnosis is key. Degener Neurol Neuromuscul Dis. 2019;9:27-37. 4. Titulaer MJ, Lang B, Verschuuren JJ. Lambert-Eaton myasthenic syndrome: from clinical characteristics to therapeutic strategies. Lancet Neurol. 2011; Appendix:1-4. 5. Kaytal N, Govindarajan R. Pure ocular weakness as the initial manifestation of Lambert-Eaton myasthenic syndrome. Cureus. 2017;9(12):e2007. 6. Harms L, Sieb J-P, Williams AE, et al. Long-term disease history, clinical symptoms, health status, and healthcare utilization in patients suffering from Lambert Eaton myasthenic syndrome: results of a patient interview survey in Germany. J Med Econ. 2012;15(3):521-530.