A 60 year old male who has been smoking 20 cigarettes a
day for the last 40 years, presents with fatiguable weakness of the proximal
limb muscles and trunk. There is no ptosis. He complains of a dry mouth, he
has problems with micturition and he has erectile failure.
In this patient the tendon reflexes would be:
a)
Absent and cannot be reinforced by brief maintained isometric
contraction
b)
Absent but may be reinforced by brief maintained isometric contraction
c) Exaggerated
d)
Normal
e)
Pendular
Answer: b)
The clinical features suggest the patient has
Eaton-Lambert syndrome. In this condition the tendon reflexes are usually
absent but can be reinforced by brief sustained isometric contraction. This is
called post-tetanic potentiation and is an useful sign in making the diagnosis
Revision Tip
Revise Lambert Eaton Syndrome
KEYS to SUCCESS in Medicine page 480-481
