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Hi, Trying To Get An Idea Of What These Auto

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Posted on Thu, 25 Apr 2019
Question: Hi, trying to get an idea of what these auto antibodies mean. I have POSITVE to GM1 Ganglioside IGG, and GD1B ganglioside. I also have POSITVE to paroneoplastic P/Q voltage gated calcium channel AB. I started having issues a bout a year ago. Weakness and it progressed first thought was CNS lupus. ( since i have lupus). Stronger immune therapy and symtoms improved slightly . Then it progressed from my legs to my arm and hand weakness and electrical shock pain. Diagnosed with ataxic gait and absent reflex of left ankle. Then the weakness progressed to my face. Right eye ptsosis and lower lip drooping. Developed weakness in my tongue. Hoarse voice and issues swallowing. My neurologist ordered the antibody testing and that was what came back POSITVE. He ordered IVIG (5 days). I am about 1.5 weeks since I did IVIG I have regained some of my muscle strength back and feel my walking is improving. My face looks almost completely normal. The only thing I have noticed since the IVIG is electrical shock pains coming on especially in my hands and feet and lower leg. Worst towards the night. Could this be the ivig healing the nerves? Also I am scheduled to see neuro/ muscular neurologist my neurologists partner in a few weeks just trying to get an idea of what is happening to me and what these antibodies mean??? As of now I am scheduled for another round of ivig towards the end of this month.
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Answered by Dr. Dr. Erion Spaho (3 hours later)
Brief Answer:
Lambert-Eaton myasthenic syndrome to consider.

Detailed Answer:
Hello and welcome to 'Ask a Doctor' service.

I have checked the attached ECG, read your query, and here is my advice.

Antiganglioside antibodies are found positive in a number of neurological conditions such as myasthenic syndromes, peripheral neuropathies, etc.

Antibodies to calcium channels in the other hand are a specific feature for Lambert-Eaton myasthenic syndrome (LEMS) a condition associated in more than the half of cases with an underlying disease, particularly small cell carcinoma of the lung.

In my opinion, your symptoms and tests findings point towards LEMS.

Besides further neurological evaluation, in my opinion, you need a CT scan of the lungs in order to exclude small cell carcinoma.

Hope you found the answer helpful.

Let me know if I can assist you further.

Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Answered by
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Dr. Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 4501 Questions

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Hi, Trying To Get An Idea Of What These Auto

Brief Answer: Lambert-Eaton myasthenic syndrome to consider. Detailed Answer: Hello and welcome to 'Ask a Doctor' service. I have checked the attached ECG, read your query, and here is my advice. Antiganglioside antibodies are found positive in a number of neurological conditions such as myasthenic syndromes, peripheral neuropathies, etc. Antibodies to calcium channels in the other hand are a specific feature for Lambert-Eaton myasthenic syndrome (LEMS) a condition associated in more than the half of cases with an underlying disease, particularly small cell carcinoma of the lung. In my opinion, your symptoms and tests findings point towards LEMS. Besides further neurological evaluation, in my opinion, you need a CT scan of the lungs in order to exclude small cell carcinoma. Hope you found the answer helpful. Let me know if I can assist you further.