-No sensory, speech, urinary, or significant pain symptoms, but there is noticeable weight loss (24 pounds)!
-History of refractory constipation
NMJ VS Muscles dz?
NEUROLOGICAL EXAMINATION: PROXIMAL MUSCLE WEAKNESS, ABSENT REFLEXES. NONREACTIVE PUPILE B/L NO DIPLOPIA,
Autonomic involvement , pre synaptic ?
Diagnostic workup
L
NCS :incremental response after maximal exercise. EMG shows myopathic changes Anti-VGCC antibodies Positive * DX
Lambert-Eaton myasthenic syndrome
It is time to screen for underlying malignancy CT chest, abdomen, and pelvis
Lung cancer with biopsy confirmed SCLC
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