Lambert-Eaton Myasthenic Syndrome Complicated by anti-GABAB Receptor Encephalitis

Kazuki Yamada; Hiroaki Yaguchi; Kaede Ishikawa; Daiki Tanaka; Yuki Oshima; Keiichi Mizushima; Hisashi Uwatoko; Shinichi Shirai; Ikuko Iwata; Masaaki Matsushima; Keiko Tanaka; Ichiro Yabe

doi:10.2169/internalmedicine.2569-23

This article has now been updated. Please use the final version.

Lambert-Eaton Myasthenic Syndrome Complicated by anti-GABA_B Receptor Encephalitis

Kazuki Yamada, Hiroaki Yaguchi, Kaede Ishikawa, Daiki Tanaka, Yuki Oshima, Keiichi Mizushima, Hisashi Uwatoko, Shinichi Shirai, Ikuko Iwata, Masaaki Matsushima, Keiko Tanaka, Ichiro Yabe

Author information

Kazuki Yamada
Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
Hiroaki Yaguchi
Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
Kaede Ishikawa
Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
Daiki Tanaka
Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
Yuki Oshima
Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
Keiichi Mizushima
Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
Hisashi Uwatoko
Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
Shinichi Shirai
Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
Ikuko Iwata
Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
Masaaki Matsushima
Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
Keiko Tanaka
Department of Animal Model Development, Brain Research Institute, Niigata University, Japan
Ichiro Yabe
Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan

Keywords: Lambert-Eaton myasthenic syndrome (LEMS), autoimmune encephalitis, GABA_B receptor antibodies, central apnea

JOURNAL OPEN ACCESS Advance online publication

Article ID: 2569-23

DOI https://doi.org/10.2169/internalmedicine.2569-23

The final version of this article is now available: Vol. 63 (2024), No. 9 pp. 1295-1300

Details

Abstract

A 74-year-old man experienced diplopia, generalized muscle weakness, and acute respiratory failure. He was diagnosed with Lambert-Eaton myasthenic syndrome (LEMS) and treated with immunotherapy, but no improvement was observed, and additional symptoms, including central apnea and hallucinations, appeared. Subsequent serum and cerebrospinal fluid (CSF) analyses confirmed the presence of GABA_B receptor antibodies, indicating the coexistence of autoimmune encephalitis. Although there were no findings of malignancy, it is highly likely that occult small-cell lung carcinoma was present. When atypical symptoms occur in patients with LEMS, it is important to consider the possibility of concomitant autoimmune encephalitis.

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