New onset Lambert–Eaton myasthenic syndrome as an unexpected cause of delayed recovery from general anesthesia after thyroidectomy

Lambert-Eaton myasthenic syndrome as a cause of persistent neuromuscular weakness after a mediastinoscopic biopsy -A case report-

There are many causes of prolonged postoperative muscle weakness, including drugs, residual anesthetics, cerebrovascular events, electrolyte imbalance, hypothermia, and neuromuscular disease. Neuromuscular diseases are relatively rare, with the most common being myasthenia gravis and Lambert-Eaton myasthenic syndrome (LEMS). We report an unusual case in which a patient who was given a muscle relaxant during mediastinoscopy developed postoperative muscle weakness that was ultimately diagnosed as secondary to LEMS.

Lambert-eaton myasthenic syndrome in a patient with small-cell lung cancer

Lambert-Eaton myasthenic syndrome (LEMS), an autoimmune neuromuscular disorder, often has underlying small-cell lung cancer (SCLC). Thorough search for SCLC in patients with LEMS can result in early detection of limited-stage SCLC, one quarter of which can be successfully treated with chemotherapy and radiation therapy. To elucidate the pathogenesis, diagnosis, treatment, and prognosis of patients with SCLC and LEMS, we present a 51-year-old man who was diagnosed with LEMS and limited-stage SCLC after an 18-month history of weakness in the lower extremities. The patient exhibited a complete response in lung tumors and a resolution in LEMS symptoms after chemotherapy and radiation therapy.

Labor analgesia for the parturient with neurological disease: what does an obstetrician need to know?

Several neurological disorders including multiple sclerosis, myasthenia gravis, epilepsy, spinal cord injury, and subarachnoid hemorrhage are encountered with increasing frequency in pregnant women worldwide. Although there is absence of uniform anesthetic guidelines for pregnant patients with most of these (and other) neurological disorders, and the decision whether or not to administer regional anesthesia is based on an individual risk-to-benefit ratio on a case-by-case basis, few of these disorders contraindicate the use of neuraxial anesthesia. This article attempts to review the specific concerns for administration of labor analgesia posed by multiple sclerosis, myasthenia gravis, epilepsy, paraplegia and subarachnoid hemorrhage.