{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T22:29:27Z","timestamp":1768084167042,"version":"3.49.0"},"reference-count":45,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2012,12,20]],"date-time":"2012-12-20T00:00:00Z","timestamp":1355961600000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Annals of the New York Academy of Sciences"],"published-print":{"date-parts":[[2012,12]]},"abstract":"<jats:p>Besides antitumor therapy for patients with the paraneoplastic form of Lambert\u2013Eaton myasthenic syndrome (LEMS), the mainstay of symptomatic treatment in LEMS is 3,4\u2010diaminopyridine (3,4\u2010DAP). Data from four randomized, placebo\u2010controlled trials have revealed that muscle strength scores increased significantly with 3,4\u2010DAP. A limited meta\u2010analysis performed on two trials using the Quantitative Myasthenia Gravis score indicated that the clinical benefits seen were modest. Meta\u2010analysis of the mean change in compound muscle action potential amplitude following 3,4\u2010DAP treatment revealed a significant improvement compared to placebo. However, most patients with noncancer LEMS require long\u2010term immunosuppression, usually with prednisolone and azathioprine. A single crossover study has previously shown significant short\u2010term benefit in limb strength following intravenous immunoglobulin, and there are isolated case reports of medium term benefit from rituximab. Overall, a combination of symptomatic treatment with 3,4\u2010DAP and immunosuppression, with or without antitumor therapy, is often successful for most LEMS patients, with other more aggressive regimens rarely needed.<\/jats:p>","DOI":"10.1111\/j.1749-6632.2012.06769.x","type":"journal-article","created":{"date-parts":[[2012,12,22]],"date-time":"2012-12-22T03:28:36Z","timestamp":1356146916000},"page":"78-84","source":"Crossref","is-referenced-by-count":31,"title":["Treatment in Lambert\u2013Eaton myasthenic syndrome"],"prefix":"10.1111","volume":"1275","author":[{"given":"Paul","family":"Maddison","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,12,20]]},"reference":[{"key":"e_1_2_8_2_2","first-page":"612","article-title":"Defect of neuromuscular conduction associated with malignant neoplasms","volume":"187","author":"Lambert E.H.","year":"1956","journal-title":"Am. J. 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