{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T01:40:24Z","timestamp":1789609224141,"version":"build-2803163510"},"reference-count":18,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,3,17]],"date-time":"2017-03-17T00:00:00Z","timestamp":1489708800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>One nationwide study (The Netherlands) of Lambert\u2013Eaton myasthenic syndrome (LEMS) has been published. We report LEMS epidemiology and its therapeutic response in the United States Veterans Affairs (VA) population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Medical records for all active patients (12.5 million) in the VA health system were queried for relevant ICD\u20109 codes for the period October 1, 1999 to September 30, 2013. Clinical, electrophysiologic, and serologic features were evaluated to confirm diagnosis; epidemiologic and treatment data were collected.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Point prevalence was estimated at 2.6 per 1,000,000 (confirmed cases) and 3.3 per 1,000,000 (combined confirmed and probable cases). Crude prevalence was similarly estimated at 9.2 and 10.9 per 1,000,000 respectively. A total of 18 of 48 (38%) patients received 3,4\u2010diaminopyridine (3,4\u2010DAP); 14 of 18 (78%) improved.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This investigation was a large North American epidemiologic study of LEMS. LEMS prevalence in the national VA population was found to be similar to previously published rates in other large international populations. Most patients experienced improvement with therapy, including a majority with 3,4\u2010DAP. <jats:italic>Muscle Nerve<\/jats:italic> <jats:bold>56<\/jats:bold>: 421\u2013426, 2017<\/jats:p><\/jats:sec>","DOI":"10.1002\/mus.25520","type":"journal-article","created":{"date-parts":[[2016,12,20]],"date-time":"2016-12-20T17:49:14Z","timestamp":1482256154000},"page":"421-426","source":"Crossref","is-referenced-by-count":40,"title":["Lambert\u2013Eaton myasthenic syndrome: Epidemiology and therapeutic response in the national veterans affairs population"],"prefix":"10.1002","volume":"56","author":[{"given":"Daniel C.","family":"Abenroth","sequence":"first","affiliation":[{"name":"Department of Neurology Veterans Affairs Medical Center Salt Lake City Utah USA"},{"name":"Department of Neurology University of Utah Health 729 Arapeen Drive Salt Lake City Utah 84108 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. Gordon","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Utah Health 729 Arapeen Drive Salt Lake City Utah 84108 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John E.","family":"Greenlee","sequence":"additional","affiliation":[{"name":"Department of Neurology Veterans Affairs Medical Center Salt Lake City Utah USA"},{"name":"Department of Neurology University of Utah Health 729 Arapeen Drive Salt Lake City Utah 84108 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon D.","family":"Austin","sequence":"additional","affiliation":[{"name":"Department of Research Veterans Affairs Medical Center Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacey L.","family":"Clardy","sequence":"additional","affiliation":[{"name":"Department of Neurology Veterans Affairs Medical Center Salt Lake City Utah USA"},{"name":"Department of Neurology University of Utah Health 729 Arapeen Drive Salt Lake City Utah 84108 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,3,17]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"612","article-title":"Defect of neuromuscular conduction associated with malignant neoplasms","volume":"187","author":"Lambert EH","year":"1956","journal-title":"Am J Physiol"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/111.3.577"},{"key":"e_1_2_6_4_1","first-page":"397","article-title":"et al.","volume":"63","author":"Wirtz PW","year":"2004","journal-title":"The epidemiology of the Lambert\u2010Eaton myasthenic syndrome in the Netherlands. Neurology"},{"key":"e_1_2_6_5_1","first-page":"698","article-title":"et al.","volume":"250","author":"Wirtz PW","year":"2003","journal-title":"The epidemiology of myasthenia gravis, Lambert\u2010Eaton myasthenic syndrome and their associated tumours in the northern part of the province of South Holland. J Neurol"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1991.00530190081019"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198912073212303"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.54.3.603"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.21422"},{"key":"e_1_2_6_10_1","first-page":"44","article-title":"et al.","volume":"86","author":"Wirtz PW","year":"2009","journal-title":"Efficacy of 3,4\u2010diaminopyridine and pyridostigmine in the treatment of Lambert\u2010Eaton myasthenic syndrome; a randomized, double\u2010blind, placebo\u2010controlled, crossover study. Clin Pharmacol Ther"},{"key":"e_1_2_6_11_1","first-page":"717","article-title":"et al.","volume":"53","author":"Oh SJ","year":"2016","journal-title":"Amifampridine phosphate (Firdapse) is effective and safe in a phase 3 clinical trial in LEMS. Muscle Nerve"},{"key":"e_1_2_6_12_1","unstructured":"DB Sanders Juel VC Harati Y Smith AG Peltier AC Marburger T Lou J-S Pascuzzi R Richman DP Xie T Jacobus LR Ales KL Jacobus DP the DAPPER Study Team 2015"},{"key":"e_1_2_6_13_1","first-page":"678","article-title":"et al.","volume":"47","author":"Bain PG","year":"1996","journal-title":"Effects of intravenous immunoglobulin on muscle weakness and calcium\u2010channel autoantibodies in the Lambert\u2010Eaton myasthenic syndrome. Neurology"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.34.4.480"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410100507"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2003-41135"},{"key":"e_1_2_6_17_1","unstructured":"VA Public Health.Tobacco use in VA infographic.http:\/\/www.publichealth.va.gov\/smoking\/professionals\/tobacco-use-infographic.asp\/. Accessed September 20 2016."},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6444a2"},{"key":"e_1_2_6_19_1","unstructured":"National Center for Veterans Analysis and Statistics August 2015.Unique veteran users report FY 2013.http:\/\/www.va.gov\/vetdata\/index.asp. Accessed September 20 2016."}],"container-title":["Muscle &amp; Nerve"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fmus.25520","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mus.25520","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,1]],"date-time":"2023-10-01T20:59:40Z","timestamp":1696193980000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/mus.25520"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,3,17]]},"references-count":18,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2017,9]]}},"alternative-id":["10.1002\/mus.25520"],"URL":"https:\/\/doi.org\/10.1002\/mus.25520","archive":["Portico"],"relation":{},"ISSN":["0148-639X","1097-4598"],"issn-type":[{"value":"0148-639X","type":"print"},{"value":"1097-4598","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,3,17]]}}}