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IS IT LEMS OR MG?

Lambert-Eaton myasthenic syndrome (LEMS) and myasthenia gravis (MG) share several hallmark signs and symptoms, including muscle weakness and oculobulbar involvement 1,2

One way to differentiate these two immune-mediated neuromuscular disorders is to look for these specific signs and symptoms 1,2 :

LEMS MG

Symmetrical muscle weakness

Typically asymmetrical muscle weakness

Caudal-to-cranial pattern of spread

Late-onset and mild oculobulbar involvement

Absent or diminished tendon reflexes

Cranial-to-caudal pattern of spread

Early and prominent oculobulbar involvement

Preserved tendon reflexes

Autonomic dysfunction

Transient improvement of muscle strength with exercise, with fatigue that follows

Antibodies to voltage-gated calcium channels (VGCC) are usually found

No autonomic dysfunction

Muscle weakness worsens with exercise

Antibodies to AChR or MuSK are usually found

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