Lambert Eaton myasthenic syndrome (LEMS): electromyogram (EMG)

Repetitive nerve stimulation (RNS)

• This measures the muscle response to repetitive stimulation of the nerve for 10 seconds
• Stimulation at 30-50Hz shows a 2-20% incremental response
• Stimulation at 2-5Hz shows a 10% decremental response

Exercise facilitation

Single fiber EMG (SFEMG)

Other EMG features

References

1. Sabater L, Titulaer M, Saiz A, Verschuuren J, Gure AO, Graus F. SOX1 antibodies are makers of paraneoplastic Lambert-Eaton myasthenic syndrome. Neurology 2008; 70:924-928.
2. Gilhus NE. Lambert-eaton myasthenic syndrome; pathogenesis, diagnosis, and therapy. Autoimmune Dis 2011; 2011:973808.
3. Titulaer MJ, Lang B, Verschuuren JJGM. Lambert-Eaton myasthenic syndrome: from clinical characteristics to therapeutic strategies. Lancet 2011; 10:1098-1107.
4. Guan Y, Ding Q, Liu M, Niu J, Cui L. Single-fiber EMG with concentric electrodes in lambert-eaton myasthenia. Muscle Nerve 2016; 56: 253-257.
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