How is LEMS treated
Release of ACh from the presynaptic nerve terminal is facilitated by guanidine hydrochloride, 4-aminopyridine (4-AP), and 3,4-diaminopyridine.
The aminopyridines, particularly 4-AP, decrease the seizure threshold. Anticholinesterases may improve symptoms in some patients.
In paraneoplastic cases, successful treatment of the underlying neoplasm is the best therapy and may cause full remission of symptoms.
Although improvement after IVIG also has been reported and other immunomodulatory therapies have been utilized (i.e., PE, oral steroids), the results of these interventions are often disappointing.
