Update on treatment options for Lambert–Eaton myasthenic syndrome: focus on use of amifampridine
Sabine Lindquist, Martin StangelSection Clinical Neuroimmunology and Neurochemistry, Department of Neurology, Hannover Medical School, Hannover, GermanyAbstract: In Lambert–Eaton myasthenic syndrome (LEMS), antibodies against presynaptic voltage-gated calcium channels reduce the quanta...
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Dove Medical Press
2011
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oai:doaj.org-article:ee6bc4606bf44784a46970bea86e25732021-12-02T01:29:41ZUpdate on treatment options for Lambert–Eaton myasthenic syndrome: focus on use of amifampridine1176-63281178-2021https://doaj.org/article/ee6bc4606bf44784a46970bea86e25732011-05-01T00:00:00Zhttp://www.dovepress.com/update-on-treatment-options-for-lambertndasheaton-myasthenic-syndrome--a7547https://doaj.org/toc/1176-6328https://doaj.org/toc/1178-2021Sabine Lindquist, Martin StangelSection Clinical Neuroimmunology and Neurochemistry, Department of Neurology, Hannover Medical School, Hannover, GermanyAbstract: In Lambert–Eaton myasthenic syndrome (LEMS), antibodies against presynaptic voltage-gated calcium channels reduce the quantal release of acetylcholine, causing muscle weakness and autonomic dysfunction. More than half of the affected patients have associated small cell lung cancer, and thorough screening for an underlying malignancy is crucial. The mainstay of treatment for LEMS is symptomatic but immunotherapy is needed in more severely affected patients. Symptomatic therapies aim at increasing the concentration of acetylcholine at the muscle endplate. While acetylcholinesterase inhibitors were the first drugs to be used for the amelioration of symptoms, 3,4-diaminopyridine (3,4-DAP, amifampridine) has been shown to be more effective. 3,4-DAP blocks presynaptic potassium channels, thereby prolonging the action potential and increasing presynaptic calcium concentrations. This then results in increased quantal release of acetylcholine. The efficacy of 3,4-DAP for increasing muscle strength and resting compound muscle action potentials has been demonstrated by four placebo-controlled trials. Side effects are usually mild, and the most frequently reported are paresthesias. The most common serious adverse events are epileptic seizures. 3,4-DAP is currently the treatment of choice in patients with Lambert–Eaton myasthenic syndrome.Keywords: Lambert–Eaton myasthenic syndrome, symptomatic treatment, management, 3,4-diaminopyridine, amifampridineLindquist SStangel MDove Medical PressarticleNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol 2011, Iss Issue 1, Pp 341-349 (2011) |
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Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 |
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Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Lindquist S Stangel M Update on treatment options for Lambert–Eaton myasthenic syndrome: focus on use of amifampridine |
| description |
Sabine Lindquist, Martin StangelSection Clinical Neuroimmunology and Neurochemistry, Department of Neurology, Hannover Medical School, Hannover, GermanyAbstract: In Lambert–Eaton myasthenic syndrome (LEMS), antibodies against presynaptic voltage-gated calcium channels reduce the quantal release of acetylcholine, causing muscle weakness and autonomic dysfunction. More than half of the affected patients have associated small cell lung cancer, and thorough screening for an underlying malignancy is crucial. The mainstay of treatment for LEMS is symptomatic but immunotherapy is needed in more severely affected patients. Symptomatic therapies aim at increasing the concentration of acetylcholine at the muscle endplate. While acetylcholinesterase inhibitors were the first drugs to be used for the amelioration of symptoms, 3,4-diaminopyridine (3,4-DAP, amifampridine) has been shown to be more effective. 3,4-DAP blocks presynaptic potassium channels, thereby prolonging the action potential and increasing presynaptic calcium concentrations. This then results in increased quantal release of acetylcholine. The efficacy of 3,4-DAP for increasing muscle strength and resting compound muscle action potentials has been demonstrated by four placebo-controlled trials. Side effects are usually mild, and the most frequently reported are paresthesias. The most common serious adverse events are epileptic seizures. 3,4-DAP is currently the treatment of choice in patients with Lambert–Eaton myasthenic syndrome.Keywords: Lambert–Eaton myasthenic syndrome, symptomatic treatment, management, 3,4-diaminopyridine, amifampridine |
| format |
article |
| author |
Lindquist S Stangel M |
| author_facet |
Lindquist S Stangel M |
| author_sort |
Lindquist S |
| title |
Update on treatment options for Lambert–Eaton myasthenic syndrome: focus on use of amifampridine |
| title_short |
Update on treatment options for Lambert–Eaton myasthenic syndrome: focus on use of amifampridine |
| title_full |
Update on treatment options for Lambert–Eaton myasthenic syndrome: focus on use of amifampridine |
| title_fullStr |
Update on treatment options for Lambert–Eaton myasthenic syndrome: focus on use of amifampridine |
| title_full_unstemmed |
Update on treatment options for Lambert–Eaton myasthenic syndrome: focus on use of amifampridine |
| title_sort |
update on treatment options for lambert–eaton myasthenic syndrome: focus on use of amifampridine |
| publisher |
Dove Medical Press |
| publishDate |
2011 |
| url |
https://doaj.org/article/ee6bc4606bf44784a46970bea86e2573 |
| work_keys_str_mv |
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