Lambert-Eaton myasthenic syndrome.

@article{Mareska2004LambertEatonMS,
  title={Lambert-Eaton myasthenic syndrome.},
  author={Michael C Mareska and Laurie Gutmann},
  journal={Seminars in neurology},
  year={2004},
  volume={24 2},
  pages={
          149-53
        }
}
Lambert-Eaton myasthenic syndrome (LEMS) is an idiopathic or paraneoplastic syndrome producing antibodies against presynaptic voltage-gated P/Q calcium channels. This decreases calcium entry into the presynaptic terminal, which prevents binding of vesicles to the presynaptic membrane and acetylcholine release. LEMS is most often associated with small cell lung cancer, although idiopathic presentations comprise approximately 40% of the cases. The most common initial complaint is proximal muscle… 

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Different effects on Ca2+ flux inhibition by LEMS IgGs on the one hand and by L- and N-type channel antagonists on the other suggest that in many LEMS patients the autoantibodies target other VGCC subtypes besides L- or N-types, and that these are important in inducing the myasthenic disorder.