Titulaer et al reported a score for use in patients with the Lambert-Eaton Myasthenic Syndrome (LEMS). This can help to identify a patient who should be evaluated for small cell undifferentiated lung carcinoma. The authors are from the Dutch-English Lambert-Eaton Myasthenic Syndrome Tumor Association.
Patient selection: Lambert-Eaton Myasthenia Syndrome (LEMS)
Parameters:
(1) dysarthria, dysphagia, muscle weakness (D)
(2) erectile dysfunction (E)
(3) loss of weight (L)
(4) tobacco use at onset (T)
(5) age at onet (A)
(6) performance on the Karnofsky Performance Scale or KPS (P)
Parameter |
Finding |
Points |
---|---|---|
dysarthria, dysphagia, neck weakness, bulbar weakness, difficulty chewing |
absent |
0 |
|
present |
1 |
male with erectile dysfunction |
absent |
0 |
|
present |
1 |
weight loss |
< 5% |
0 |
|
>= 5% |
1 |
using tobacco at onset |
no |
0 |
|
yes |
1 |
age at onset |
< 50 years of age |
0 |
|
>= 50 years of age |
1 |
performance on KPS |
70 to 100 |
0 |
|
10 to 60 |
1 |
total DELTA-P score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 6
• The higher the score the greater the risk of the patient having a small cell lung cancer.
Total DELTA-P |
Percent with Small Cell Lung Cancer |
0 |
0% |
1 |
2.6% |
2 |
29% |
3 |
84% |
4 |
94% |
5 |
97% |
6 |
100% |
Purpose: To determine if a patient with the Lambert-Eaton Myasthenic Syndrome (LEMS) should be screened for small cell lung cancer based on the DELTA-P score.
Specialty: Neurology, Hematology Oncology
Objective: severity, prognosis, stage
ICD-10: G70, C34,