Abstract
Autonomie innervation to the eye and ocular adnexae was assessed in seven patients with Lambert-Eaton Myasthenic Syndrome and 50 age-matched control subjects. Pupil responses to light were abnormal in 69% of LEMS patients, compared with 18% of the control group. Reflex tear production—a screening test for parasym-pathetic innervation to the lacrimal gland—was below the accepted normal limit in 69% of LEMS patients. Parasympathetic and sympathetic denervation hypersensitivity of the iris musculature were individually present in 57% of LEMS patients, compared with 6% of control subjects. The association between autonomie dysfunction and Lambert-Eaton Myasthenic Syndrome is discussed.
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References
Lambert EH and Rooke ED : Myasthenic state and Lung Cancer. Inc. Brain L, Norris F, eds. The remote effects of cancer on the nervous system. Contemporary neurology symposia. New York: Brune and Stratton Ind 1965: 67–80.
O'Neill JH, Murray NMF, Newsom-Davis J : The Lambert-Eaton Myasthenic Syndrome: a review of 50 cases. Brain, 1988, 111: 577–96.
Lang B, Newsom-Davis J, W-Wray D, Vincent A, Murray N : Autoimmune aetiology for myasthenic (Lambert-Eaton) syndrome. Lancet 1981, ii: 224–6.
Fukunaga H, Engel AG, Osame M, Lambert EH : Paucity of presynaptic membrane active zones in the Lambert-Eaton Myasthenic syndrome revealed by freeze fracture electron microscopy. Neurology (NY) 1982, 32: A222.
Lang B, Newsom-Davis J, Prior C, W-Wray D : Antibodies to motor nerve terminals: an electrophysiological study of a human Myasthenic syndrome transferred to mouse. J Physiol (Lond), 1983, 344: 335–45.
Lang B, Newsom-Davis J, Peers C, Prior C, W-Wray D : The effect of Myasthenic syndrome antibody on presynaptic calcium channels in the mouse. J Physiol (Lond), 1987, 390: 257–70.
Fukunaga H, Engel AG, Lang B, Newsom-Davis J, Vincent A : Passive transfer to Lambert-Eaton Myasthenic syndrome with IgG from man to mouse depleted the presynaptic membrane active zones. Proc Nat Acad Sci, USA 1983, 80: 7636–40.
Roberts A, Perera S, Lang B, Vincent A, Newsom-Davis J : Paraneoplastic Myasthenic syndrome IgG inhibits 45CA2+ flux in a human small cell carcinoma line. Nature, 1985, 317: 737–9.
Rubenstein AE, Horowitz SH, Bender AN : Cholinergic dysautonomia and Eaton-Lambert Syndrome. Neurology 1979, 29: 720–3.
Khurana RK, Koski CL, Mayer RF : Dysautonomia in Eaton-Lambert syndrome. Ann Neurol 1983, 14: 123.
Mamdami MB, Walsh RL, Rubino FA, Brannegan RT, Hwang MH : Autonomic dysfunction and Eaton-Lambert syndrome. J Aut Nerv Syst 1985, 12: 315–20.
Miller SD and Thompson HS : Edge-light pupil cycle time. Br J Ophthalmol 1978, 62: 495–500.
Scheie HG : Site of disturbance in Adie's syndrome. Arch Ophthalmol 1940, 24: 225–37.
Clark CV and Mapstone R : Parasympathetic denervation hypersensitivity of the iris in ocular hypertension. Invest Ophthalmol Vis Sci 1987, 28: 1732–34.
Clark CV : Ocular Autonomic nerve function in proliferative diabetic retinopathy. Eye 1988, 2: 96–101.
Newell FW : Ophthalmology principles and concepts. 5th ed St Louis: CV Mosby Co 1982, 45.
Newell FW : Ophthalmology principles and concepts. 5th ed St Louis: CV Mosby Co 1982, 226.
Clark CV and Mapstone R : Pupil cycle time in primary closed-angle glaucoma. Can J Ophthalmol 1986, 21: 88–91.
Thompson HS : Hippus Arch Internal Med 1969, 123: 598.
Thompson HS, Franceschetti AT, Thompson PM : Hippus. Semantic and historic considerations of the word. Am J Ophthalmol 1971, 17: 1116–120.
Lowenstein O, Feinberg R, Loewenfeld IE : Pupillary movements during acute and chronic fatigue. Invest Ophthalmol 1963, 2: 138–57.
Yoss RE, Mayer NJ, Hollenhorst RW : Pupil size and spontaneous pupillary waves associated with alertness, drowsiness and sleep. Neurology 1970; 20: 545–54.
Stark L and Cornsweet T : Testing a servoanalytic hypothesis for pupil oscillation. Science 1958, 127: 588.
Weinstein JM, Van Gilder JC, Thompson HS : Pupil cycle time in optic nerve compression. Am J Ophthalmol 1980, 89: 263–7.
Ukai K, Higashi JT, Ishikawa S : Edge-light pupil oscillation of optic neuritis. Neuro-ophthalmol 1980, 1: 33–43.
Cox TA, Thompson HS, Hayreh SS, Snyder JE : Visual evoked potential and pupillary signs. Arch Ophthalmol 1982, 100: 1603–7.
Martyn CN and Ewing DJ : Pupil cycle time: a simple way of measuring an autonomic reflex. J Neurol Neurosurg Psychiat 1986, 49: 771–4.
Fukuoka T, Engel AG, Lang B, Newsom-Davis J, Prior C, W-Wray D : Lambert-Eaton myasthenic syndrome. 1. Early morphologic effects of IgC on the presynaptic membrane active zones. Ann Neurol, 1987, 22: 193–9.
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Clark, C., Newsom-Davis, J. & Sanders, M. Ocular autonomic nerve function in Lambert-Eaton myasthenic syndrome. Eye 4, 473–481 (1990). https://doi.org/10.1038/eye.1990.61
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DOI: https://doi.org/10.1038/eye.1990.61
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