(Myasthenic myopathic syndrome)
EATON-LAMBERT SYNDROME is seen in small cell carcinoma of the lung. There is weakness of pelvic and shoulder girdle muscles including muscles of thigh and arm with loss of tendon reflexes. Ocular and bulbar muscles are not involved. Knee jerk is often lost, weakness is usually improved after exercise which is not seen in typical myasthenia. The disease is possibly due to a defect in the calcium mediated release of acetyl choline from nerve terminals. Diagnosis is confirmed electrophysiologically by observing increased muscle response to repetitive stimulation. Guanidine 350 mg 2-4 times a day may give relief. Plasmapharesis and immunosuppressive therapy are also helpful.