Late onset cerebellar ataxia syndrome after non-paraneoplastic Lambert-Eaton myasthenic syndrome: a case study

David P Randall; Matthew C Randall

doi:10.1186/s12883-024-03983-8

Late onset cerebellar ataxia syndrome after non-paraneoplastic Lambert-Eaton myasthenic syndrome: a case study

BMC Neurol. 2025 Jan 2;25(1):2. doi: 10.1186/s12883-024-03983-8.

Authors

David P Randall¹, Matthew C Randall^{2

3}

Affiliations

¹ Neuromuscular Neurology, Advocate Health, 1850 Dempster Street, Park Ridge, IL, 60068, USA. [email protected].
² Neuromuscular Neurology, Advocate Health, 1850 Dempster Street, Park Ridge, IL, 60068, USA.
³ Norton College of Medicine, Upstate Medical University, Syracuse, NY, USA.

Abstract

This is an unusual case of voltage gated calcium channel (VGCC) antibodies leading to two distinct and chronologically separated neurologic syndromes without the presence of an underlying neoplasm. Lambert Eaton Myasthenic Syndrome (LEMS) presented five years prior to cerebellar ataxia. Both LEMS and cerebellar ataxia were responsive to treatment, but not the same therapy. He was diagnosed with LEMS through history, exam, electromyography/nerve conduction studies (EMG/NCS) with repetitive nerve stimulation (RNS) and antibody testing. He was treated with 3,4 diaminopyridine (3,4 DAP) with an excellent response. Five years later, he developed acute ataxia. The patient required months of intensive and continued immunomodulating therapy.

Keywords: Cerebellar ataxia; Lambert-Eaton myasthenic syndrome; Paraneoplastic cerebellar syndrome; Voltage-gated calcium channel antibodies.

Publication types

Case Reports

MeSH terms

Cerebellar Ataxia* / complications
Cerebellar Ataxia* / diagnosis
Cerebellar Ataxia* / etiology
Electromyography
Humans
Lambert-Eaton Myasthenic Syndrome* / complications
Lambert-Eaton Myasthenic Syndrome* / diagnosis
Male
Middle Aged
Neural Conduction / physiology