{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T22:47:02Z","timestamp":1765234022571,"version":"3.44.0"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T00:00:00Z","timestamp":1756080000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Lambert-Eaton myasthenic syndrome (LEMS) is a rare autoimmune disorder of the neuromuscular junction, with limited large-scale epidemiological data. In this study, we aimed to determine the epidemiological profile of LEMS in T\u00fcrkiye, and to assess associated malignancies, mortality, and prescription rates of pyridostigmine and amifampridine.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We identified LEMS cases through a retrospective review of clinical records for individuals with a G73.1 code entry in the national healthcare database between 2015 and 2024. Confirmed cases were classified as autoimmune (A-LEMS) or paraneoplastic (P-LEMS). Demographic, clinical, and prescription data were analyzed, and incidence and prevalence rates were calculated using official census data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 159 LEMS cases were confirmed. The median age at diagnosis was 60\u202fyears, and 55.3% of the patients were female. P-LEMS accounted for 59.7% of cases, with small cell lung cancer (SCLC) present in 55.8% of these. Annual incidence of LEMS ranged from 0.09 to 0.30 per million, and the overall 2024 prevalence was 1.11 per million. A-LEMS had a higher prevalence than P-LEMS in 2024, likely due to its lower mortality (23.4% vs. 58.9%). P-LEMS was more common in older males and predominantly associated with SCLC. Pyridostigmine was prescribed to 65.4% of patients, and amifampridine to 24.5%, with both treatments more frequently used in A-LEMS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>This is the first nationwide epidemiological study of LEMS in T\u00fcrkiye, revealing lower incidence and prevalence rates than in other countries. This study provides valuable large-scale epidemiological data, enriching the global understanding of this rare disorder.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2025.1667540","type":"journal-article","created":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T05:26:06Z","timestamp":1756099566000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Epidemiological analysis of Lambert-Eaton myasthenic syndrome in T\u00fcrkiye: insights from a nationwide electronic health database"],"prefix":"10.3389","volume":"16","author":[{"given":"Berin","family":"Inan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bilgin","family":"Ozturk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naim","family":"Ata","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suayip","family":"Birinci","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erdal","family":"Eroglu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omer","family":"Karadas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ersin","family":"Tan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zeki","family":"Odabasi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,8,25]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1016\/S1474-4422(21)00297-0","article-title":"Epidemiology, diagnostics, and biomarkers of autoimmune neuromuscular junction disorders","volume":"21","author":"Punga","year":"2022","journal-title":"Lancet Neurol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"902","DOI":"10.1200\/JCO.2010.32.0440","article-title":"Clinical Dutch-English Lambert-Eaton Myasthenic syndrome (LEMS) tumor association prediction score accurately predicts small-cell lung cancer in the LEMS","volume":"29","author":"Titulaer","year":"2011","journal-title":"J Clin Oncol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1085","DOI":"10.1212\/wnl.59.7.1085","article-title":"Postexercise facilitation of reflexes is not common in Lambert-Eaton myasthenic syndrome","volume":"59","author":"Odabasi","year":"2002","journal-title":"Neurology"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"27","DOI":"10.2147\/DNND.S192588","article-title":"Lambert-Eaton Myasthenic syndrome: early diagnosis is key","volume":"9","author":"Ivanovski","year":"2019","journal-title":"Degener Neurol Neuromuscul Dis"},{"key":"ref5","author":"Weinberg","year":"2025"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1097\/JTO.0b013e3181c3f4f1","article-title":"Prospective study into the incidence of Lambert Eaton myasthenic syndrome in small cell lung cancer","volume":"5","author":"Payne","year":"2010","journal-title":"J Thorac Oncol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1002\/mus.20332","article-title":"Lambert-Eaton myasthenic syndrome has a more progressive course in patients with lung cancer","volume":"32","author":"Wirtz","year":"2005","journal-title":"Muscle Nerve"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1016\/j.jocn.2019.04.003","article-title":"Clinical characteristics and long term follow-up of Lambert-Eaton myasthenia syndrome in patients with and without small cell lung cancer","volume":"65","author":"Liu","year":"2019","journal-title":"J Clin Neurosci"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"10546","DOI":"10.1038\/s41598-020-67571-9","article-title":"Lung cancer prediction in Lambert-Eaton myasthenic syndrome in a prospective cohort","volume":"10","author":"Maddison","year":"2020","journal-title":"Sci Rep"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1212\/01.wnl.0000130254.27019.14","article-title":"The epidemiology of the Lambert-Eaton myasthenic syndrome in the Netherlands","volume":"63","author":"Wirtz","year":"2004","journal-title":"Neurology"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1002\/mus.25520","article-title":"Lambert-Eaton myasthenic syndrome: epidemiology and therapeutic response in the national veterans affairs population","volume":"56","author":"Abenroth","year":"2017","journal-title":"Muscle Nerve"},{"key":"ref12","year":""},{"key":"ref13","doi-asserted-by":"publisher","first-page":"698","DOI":"10.1007\/s00415-003-1063-7","article-title":"The epidemiology of myasthenia gravis, Lambert-Eaton myasthenic syndrome and their associated tumours in the northern part of the province of South Holland","volume":"250","author":"Wirtz","year":"2003","journal-title":"J Neurol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"304","DOI":"10.1212\/WNL.0000000000003504","article-title":"A population-based epidemiologic study of adult neuromuscular disease in the Republic of Ireland","volume":"88","author":"Lefter","year":"2017","journal-title":"Neurology"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"e000291","DOI":"10.1136\/bmjno-2022-000291","article-title":"Nationwide survey of Lambert-Eaton myasthenic syndrome in Japan","volume":"4","author":"Yoshikawa","year":"2022","journal-title":"BMJ Neurol Open"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"e511","DOI":"10.1212\/WNL.0000000000008747","article-title":"Long-term follow-up, quality of life, and survival of patients with Lambert-Eaton myasthenic syndrome","volume":"94","author":"Lipka","year":"2020","journal-title":"Neurology"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"4539","DOI":"10.1200\/JCO.2005.04.4859","article-title":"Changing epidemiology of small-cell lung cancer in the United States over the last 30 years: analysis of the surveillance, epidemiologic, and end results database","volume":"24","author":"Govindan","year":"2006","journal-title":"J Clin Oncol"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"640","DOI":"10.1056\/NEJMoa1916623","article-title":"The effect of advances in lung-Cancer treatment on population mortality","volume":"383","author":"Howlader","year":"2020","journal-title":"N Engl J Med"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"265","DOI":"10.3389\/fendo.2019.00265","article-title":"Autoimmune disease in women: endocrine transition and risk across the lifespan","volume":"10","author":"Desai","year":"2019","journal-title":"Front Endocrinol"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1016\/j.jneuroim.2004.10.018","article-title":"HLA and smoking in prediction and prognosis of small cell lung cancer in autoimmune Lambert-Eaton myasthenic syndrome","volume":"159","author":"Wirtz","year":"2005","journal-title":"J Neuroimmunol"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1016\/j.jneuroim.2008.05.025","article-title":"The Lambert-Eaton myasthenic syndrome 1988-2008: a clinical picture in 97 patients","volume":"201","author":"Titulaer","year":"2008","journal-title":"J Neuroimmunol"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1255","DOI":"10.1007\/s00415-004-0528-7","article-title":"Associated autoimmune diseases in patients with the Lambert-Eaton myasthenic syndrome and their families","volume":"251","author":"Wirtz","year":"2004","journal-title":"J Neurol"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1016\/s0303-8467(02)00054-9","article-title":"Differences in clinical features between the Lambert-Eaton myasthenic syndrome with and without cancer: an analysis of 227 published cases","volume":"104","author":"Wirtz","year":"2002","journal-title":"Clin Neurol Neurosurg"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1038\/clpt.2009.35","article-title":"Efficacy of 3,4-diaminopyridine and pyridostigmine in the treatment of Lambert-Eaton myasthenic syndrome: a randomized, double-blind, placebo-controlled, crossover study","volume":"86","author":"Wirtz","year":"2009","journal-title":"Clin Pharmacol Ther"},{"key":"ref25","author":"Weinberg","year":"2024"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"353","DOI":"10.3988\/jcn.2024.0018","article-title":"Amifampridines are the Most effective drugs for treating Lambert-Eaton Myasthenic syndrome with a focus on pediatric Lambert-Eaton Myasthenic syndrome","volume":"20","author":"Oh","year":"2024","journal-title":"J Clin Neurol"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"991","DOI":"10.1080\/1744666X.2020.1670061","article-title":"Amifampridine for the treatment of Lambert-Eaton myasthenic syndrome","volume":"15","author":"Oh","year":"2019","journal-title":"Expert Rev Clin Immunol"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"1071","DOI":"10.1007\/s40120-022-00354-8","article-title":"The European Lambert-Eaton Myasthenic syndrome registry: long-term outcomes following symptomatic treatment","volume":"11","author":"Meisel","year":"2022","journal-title":"Neurol Ther"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1667540\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T05:26:06Z","timestamp":1756099566000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1667540\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,25]]},"references-count":28,"alternative-id":["10.3389\/fneur.2025.1667540"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2025.1667540","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,25]]},"article-number":"1667540"}}