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The Lambert-Eaton myasthenic syndrome (LEMS) is presumed to be rare, but epidemiologic studies in large circumscribed populations have not been performed. Small cell lung carcinoma (SCLC) is said to be present in about 50% of LEMS patients, but this frequency might be subject to bias, as estimates were based on retrospective data from large specialized centers.1–4⇓⇓⇓ We established the prevalence and incidence of LEMS and the frequency of underlying SCLC in the Netherlands.
Patients and methods.
The study period ran from July 1, 1998, to July 1, 2003, and concerned the entire Netherlands, with 16,221,695 inhabitants by July 1, 2003. All eight university hospitals and eight large neurologic centers participated in this study. Patients were identified through standard hospital databases using codes 358.0 and 358.1 of the International Classification of Diseases, 9th revision, or using the Dutch neurologic coding system according to Kortbeek, or using the neuromuscular databases in the university hospitals. To overcome a possible referral bias we sent a letter to all neurologists in the Netherlands in a search for other LEMS patients, backed by additional attention to the aims of this study by publications in Dutch medical journals and presentations to neurologists and pulmonologists. Case finding was started on July …
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