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Pathology
Antibody mediated disorder causing muscle weakness, loss of reflexes and autonomic dysfunction.
Antibodies interfere with calcium dependent acetylcholine release in presynaptic junction
Both muscle strength and reflexes improve post exercise
Aetiology
Commonly a paraneoplastic phenomenon associated with small cell lung cancer
Signs
Reflexes are reduced but improve post exercise, proximal muscle weakness
Symptoms
Ataxia, orthostatic hypotension, impaired sweating, dry mouth, incontinence.
Investigations
Bloods: Voltage gated calcium channel antibodies
Imaging: Chest X-Ray and CT chest to look for lung cancer
Special tests: Nerve conduction studies and repetitive nerve stimulation show
an increase in compound muscle action potentials after voluntary
exercise..Treatment
Medical: Acetylcholine esterase inhibitors, corticosteroids, intravenous
immunoglobulin and plasma exchange
Surgical: Tumour removal
Prognosis
Dependent on prognosis of underlying cancer
Certain medications can cause deterioration in symptoms
Key Facts
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Key References
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