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

Intern Med. 2024 May 1;63(9):1295-1300. doi: 10.2169/internalmedicine.2569-23. Epub 2023 Sep 22.

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 GABAB 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.

Keywords: GABAB receptor antibodies; Lambert-Eaton myasthenic syndrome (LEMS); autoimmune encephalitis; central apnea.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Autoantibodies* / blood
  • Autoantibodies* / cerebrospinal fluid
  • Encephalitis / complications
  • Encephalitis / diagnosis
  • Encephalitis / immunology
  • Humans
  • Lambert-Eaton Myasthenic Syndrome* / complications
  • Lambert-Eaton Myasthenic Syndrome* / diagnosis
  • Lambert-Eaton Myasthenic Syndrome* / immunology
  • Male
  • Receptors, GABA-B* / immunology
  • Small Cell Lung Carcinoma / complications
  • Small Cell Lung Carcinoma / diagnosis

Substances

  • Receptors, GABA-B
  • Autoantibodies