Case ReviewParaneoplastic Lambert–Eaton Myasthenic Syndrome With Limbic Encephalitis: Clinical Correlation With the Coexistence of Anti-VGCC and Anti-GABAB Receptor AntibodiesCho, Jonathan J. ENS, MC, USNR*; Wymer, James P. MD, PhD†Author Information *Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Florida College of Medicine, Gainesville, FL; and †Department of Neurology, McKnight Brain Institute, University of Florida College of Medicine, Gainesville, FL. Reprints: James P. Wymer, MD, PhD, Department of Neurology, McKnight Brain Institute, University of Florida College of Medicine, 1149 Newell Drive, Gainesville, FL 32611 (e-mail: [email protected]). The authors report no conflicts of interest. J. J. Cho and J. P. Wymer had full access to all the data in these case reports and take responsibility for the integrity of the data and the accuracy of the results. Journal of Clinical Neuromuscular Disease: December 2017 - Volume 19 - Issue 2 - p 84-88 doi: 10.1097/CND.0000000000000192 Buy Metrics Abstract Objective: To characterize Lambert–Eaton myasthenic syndrome and limbic encephalitis with coexistent voltage-gated calcium channel (VGCC) antibody and γ-aminobutyric acid (GABA) B receptor antibody. Methods: Case study. Results: A 57-year-old man presented with 6 months of weakness, unsteadiness, and vision difficulties. Examination revealed proximal weakness and diminished reflexes. Electrodiagnostic study revealed low-amplitude motor potentials and facilitation on high-frequency stimulation. Laboratory evaluation identified P/Q-type VGCC antibody. Positron emission tomography identified a mediastinal lesion, confirmed as small-cell lung carcinoma. The patient developed confusion and seizures. Cerebrospinal fluid analysis identified antibodies to GABAB receptor. Conclusions: This case describes a patient with Lambert–Eaton myasthenic syndrome, limbic encephalitis, and autoantibodies to VGCC and GABAB receptor. Atypical presentation of paraneoplastic neurological syndromes could indicate the presence of a second antibody that may have significant impact on therapy. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.