Lambert-Eaton myasthenic syndrome (LEMS) is a rare autoimmune condition in which the immune system produces autoantibodies that mistakenly attack the neuromuscular junction, the region where the nerve cells meet the muscle cells. This affects the communication between nerve cells and muscles. As a result, the muscles weaken over time, causing the symptoms associated with LEMS.
Muscles affected by LEMS
LEMS predominantly affects the voluntary muscles that help the body move at will. But the autonomic nervous system that controls involuntary bodily functions, such as eye responses to light, can also be affected.
Eye muscle weakness is uncommon in LEMS patients and therefore is not easily identified as a LEMS symptom. However, several eye problems have been described in patients with LEMS.
Eye problems reported in LEMS
A study reviewed the medical records of LEMS patients with eye symptoms. They included:
- Ptosis or droopy eyelids
- Diplopia or double vision
- Reduced vision
- Dry eyes
- Abnormal eye movements
- Strabismus or cross-eyes
- Pupillary dysfunction
- Blurry vision, causing headache
Limb weakness is the characteristic symptom of patients with LEMS, while eye muscle weakness is typical of a related autoimmune condition called myasthenia gravis. LEMS and myasthenia gravis both affect the neuromuscular junction, but their clinical manifestation differs significantly. Therefore, LEMS patients presenting with eye symptoms are often misdiagnosed with myasthenia gravis. Eye symptoms must be considered along with other signs while reviewing patient medical history for a suspected LEMS diagnosis.
Last updated: Aug. 28, 2019
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