Neurogenic bladder in Lambert-Eaton myasthenic syndrome and its response to 3,4-diaminopyridine

J Neurol Sci. 2001 Jan 15;183(1):1-4. doi: 10.1016/s0022-510x(00)00460-3.

Abstract

Autonomic dysfunction, as well as neuromuscular involvement, is a common manifestation of Lambert-Eaton myasthenic syndrome (LEMS). Dry mouth and impotence have been described as typical features of autonomic dysfunction, but neurogenic bladder is infrequent or subclinical in LEMS. We report a patient with neurogenic bladder secondary to LEMS whose condition responded to 3,4-diaminopyridine (3,4-DAP). In this patient's serum, results of repeated measurement with P/Q-type VGCC antibodies proved positive, but not with N-type VGCC and synaptotagmin antibodies. A review of the literature turned up a few patients with voiding dysfunction related to LEMS, but no urodynamic studies were done on these patients. Ours is the first case in which 3,4-DAP was efficacious in treating LEMS and neurogenic bladder. Responses of 3,4-DAP in urodynamic studies suggest that in this LEMS patient neurogenic bladder was caused by defective neurotransmission both in the autonomic detrusor and skeletal abdominal muscles.

Publication types

  • Case Reports

MeSH terms

  • 4-Aminopyridine / analogs & derivatives*
  • 4-Aminopyridine / therapeutic use*
  • Aged
  • Amifampridine
  • Electromyography
  • Female
  • Humans
  • Lambert-Eaton Myasthenic Syndrome / complications*
  • Lambert-Eaton Myasthenic Syndrome / urine
  • Urinary Bladder, Neurogenic / drug therapy*
  • Urinary Bladder, Neurogenic / urine

Substances

  • 4-Aminopyridine
  • Amifampridine