<prompt> Which of the following statements about Lambe Eaten Myaesthenic syndrome is true:Tensilon test is positiveExtraocular muscles are most commonly involvedIncremental response to repeated electrical stimulationAssociated with adenocarcinoma of lung  <response>: Answer is C Incremental response to repeated electrical stimulation : Lambe Eaten Myaesthenic syndrome presents with an incremental response to repeated electrical stimulation. Lambe Eaten Myasthenia Syndrome What it is Associations Paraneoplastic syndrome Associated with - Small cell carcinoma lung - Ceain autoimmune diseases Defect Presynaptic disorder Antibodies to calcium channels PQ type Decrease in presynaptic release of Acetylcholine at Neuromuscular junction is the fundamental defect Presentation Onset usually after 40 years Men Women 5: 1 Proximal limb muscles and muscles of trunk are the most commonly involved muscles Proximal limb muscles extraocular lid muscles No fatiguability Incremental response Repeated stimulation causes increased muscle strength Reflexes : Hyporeflexia or absent reflexes Autonomic changes such as dry mouth and impotence are associated Diagnosis Repeated nerve stimulation : incremental response Radioimmune assay : Antibodies against PQ Ca2 channels Tensilon test : Negative mildly positive in some Myasthenia Gravis What it is Associations Autoimmune disorder Associated with - Thymomas - Ceain autoimmune diseases Defect Postsynaptic disorder Antibodies against ACH Receptors Decrease in number of ACH Receptors at post synaptic muscle membrane is the fundamental defect Presentation Onset Often 40 years Women Men 4: 3 Craniofascial muscles paicularly lids and extraocular muscles are the most commonly involved. Extraocular lid muscles proximal limb muscles Fatiguability Decremental response Repeated stimulation causes decreased muscle strength Reflexes : Intact No associated autonomic changes Diagnosis Repeated nerve stimulation : Decremental Radioimmune assay : - Anti ACHR antibody response - Anti-Musk antibodies Tensilon test : Characteristically Positive 