So wote nka nso sɛ wo nan reyɛ ayɛ mmerɛw? Eyi betumi ayɛ Lambert-Eaton Myasthenic Syndrome (LEMS)!

So ɛtɔ da bi a wote nka sɛ wo nan ayɛ mmerɛw, ɛyɛ den ma wo sɛ wobɛsɔre afi akongua so, wote nka sɛ woabrɛ bere a woforo antweri no? Anaasɛ wote nka sɛ woabrɛ wɔ sɛnkyerɛnne ahorow te sɛ w’aniwa a emu yɛ duru, w’ano a ɛyɛ kusuu, ne w’ani a wuhu mprenu ho? Ebia eyinom nyɛ ɔbrɛ ara kwa. Ɛnnɛ yɛbɛka tebea bi a ebia woante ho asɛm, nanso ɛfata yiye sɛ wuhu ho asɛm, Lambert-Eaton Myasthenic Syndrome, anaa ``(LEMS)`` sɛnea yɛfrɛ no tiawa no.

Dɛn ne Lambert-Eaton Myasthenic Syndrome (LEMS) a Ɛyɛ Fɛ?

Sɛ yɛbɛka no tiawa a, Lambert-Eaton Myasthenic Syndrome (LEMS) yɛ ɔyare a nipadua no tumi ko tia nyarewa. Seesei ebia woresusuw nea ɛyɛ autoimmune disorder yɛ ho. Yɛn nipadua no wɔ tumi a ɛko tia nyarewa. Eyi ne nea ɛbɔ yɛn ho ban denam mmoawa a wɔde nyarewa ba a wofi abɔnten a wɔko tia no so. Ɛte sɛ asraafo a wɔwɔ yɛn man yi mu. Nanso ɛtɔ mmere bi a, saa nipadua no mu tumi a ɛko tia nyarewa yi nkɔ yiye. Afei efi ase tow hyɛ yɛn ankasa nkwammoaa a ɛte apɔw so. Ɛno ne nea ɛkɔ so wɔ LEMS mu.

Wɔ saa `(LEMS)` yi mu no, yɛn nipadua mu ahoɔden a ɛko tia nyarewa no tow hyɛ nkitahodi a ɛda yɛn ntini a ɛma nipadua no yɛ adwuma ne yɛn ntini ahorow ntam no so . Sɛ yɛbɛka no pɛpɛɛpɛ a, wɔfrɛ saa nkitahodi yi `neuromuscular junction`. Sɛ saa nhyiam yi sɛe a, nkrasɛm a efi ntini ahorow no mu kɔ ntini ahorow no mu no sɛe. Eyi ne bere a ntini mu mmerɛwyɛ ba.

Saa mmerɛwyɛ yi taa fi ase wɔ w’asen atifi , nanso ebetumi atrɛw nkakrankakra akɔ wo nsa, ahome, amene, ne ntini a ɛkasa mu.

Hena na ɛda adi kɛse sɛ obenya saa `(LEMS)` yi?

Akuw titiriw abien na ɛka bom yɛ `(LEMS)`.

1. Ɛne kokoram wɔ abusuabɔ: Nnipa a wɔwɔ LEMS no mu bɛyɛ 60% wɔ kokoram bi. Nea abu so sen biara ne ahurututu mu kokoram a nkwammoaa nketenkete wom . Nea ɛyɛ nwonwa no, ɛtɔ mmere bi a LEMS ho sɛnkyerɛnne betumi ada adi asram anaa mfe mpo ansa na kokoram no aba. Saa nnipa yi mu dodow no ara adi boro mfe 60, wɔyɛ mmarima, na wɔde tawa mu nneɛma adi dwuma.

2. Kokoram biara nni hɔ: Nnipa 40% a aka a wɔwɔ LEMS no nni kokoram biara a wɔahu. Mpɛn pii no, wohu saa nkurɔfo yi bere a wɔadi bɛyɛ mfe 35 na wohu bio bere a wɔadi bɛyɛ mfe 60.

LEMS yɛ tebea a ɛntaa nsi koraa wɔ mmofra nkumaa mu.

So ahurututu mu kokoram nketenkete (LEMS) nkutoo na ɛne eyi wɔ abusuabɔ?

Dabi, ahurututu mu kokoram a ɛwɔ nkwammoaa nketenkete mu ne kokoram a abu so sen biara, nanso kokoram ahorow afoforo nso betumi abata LEMS ho. Nhwɛso ahorow bi ne prostate kokoram, thymoma, ne lymphoproliferative disorders. Esiane sɛ LEMS ho sɛnkyerɛnne betumi ada adi ansa na kokoram ho sɛnkyerɛnne ada adi nti, ɛho hia sɛ woyɛ nhwehwɛmu a ɛfata de hwɛ sɛ wowɔ kokoram sɛ wo duruyɛfo hu sɛ wowɔ LEMS a.

So awosu mu nsakrae na ɛde LEMS ba?

Nyansahufo gye di sɛ ebia nyarewa a nipadua no tumi ko tia nyarewa no nyinaa wɔ awosu mu abusuabɔ bi. Esiane sɛ LEMS nso yɛ yare a nipadua no tumi ko tia nyarewa nti, ebetumi aba sɛ ɛwɔ awosu mu nkɛntɛnso nso, nanso wonnya nte eyi ase yiye.

`(LEMS)` abu so dɛn?

LEMS yɛ yare a ɛntaa nsi koraa . Wobu akontaa sɛ saa tebea yi ka nnipa bɛyɛ ɔpepem 2.8 wɔ wiase nyinaa. Wɔ United States no, wɔbɔ amanneɛ sɛ nnipa bɛyɛ 400 na wɔanya LEMS. Ɛwom sɛ wonni akontaabu pɔtee biara a ɛkyerɛ nnipa dodow a wɔwɔ yɛn man yi mu de, nanso ɛda adi pefee sɛ eyi yɛ tebea a ɛntaa nsi.

Dɛn ne `(LEMS)` ho sɛnkyerɛnne?

Momma yɛnhwɛ `(LEMS)` ho sɛnkyerɛnne mmiako mmiako. Ɛnyɛ saa sɛnkyerɛnne yi nyinaa na ɛba bere koro mu wɔ obiara mu, ebia sɛnkyerɛnne ahorow bi bɛda adi ntɛm, ebi nso betumi ada adi akyiri yi.

• Ntini mu mmerɛwyɛ ne ɔbrɛ: titiriw wɔ nan a ɛwɔ soro no mu.
• Ɛyɛ den sɛ wobɛnantew: Ɛyɛ den sɛ wobɛforo antweri anaasɛ wobɛsɔre afi akongua so.
• Ntini mu yaw anaasɛ ɛyɛ den.
• Sɛ obi te nka sɛ ne akwaa ayɛ mmerɛw.
• Aniwa a ɛrehwe ase (ptosis): Eyi betumi ayɛ te sɛ nea obi ada.
• Nneɛma abien a wohu prɛko pɛ (diplopia).
• Ano ne aniwa a ɛyɛ mmerɛw (xerostomia): nnompe so tew, aniwa mu nusu so tew.
• Ayamtim.
• Fifiri a ɛso tew.
• Mu duru a ɛso tew.
• Ɛyɛ den sɛ wobɛtow nsu.
• Ɔbarima a ɔbarima ne ɔbea nna a ɛnyɛ adwuma yiye.
• Ɔkasa a ɛyɛ den (dysarthria) ne ɛyɛ den sɛ ɔbɛmene (dysphagia): Eyinom taa yɛ sɛnkyerɛnne ahorow a ɛba akyiri yi wɔ yare no mu.
• Ɔhome a ɛyɛ den (ɔhome a ɛyɛ den) ne ɔhome mu haw: Eyi nso yɛ sɛnkyerɛnne a ɛntaa nsi, a emu yɛ den a ebetumi aba wɔ yare no awiei.

Nea ɛho hia: Sɛ wowɔ saa sɛnkyerɛnne ahorow yi mu biako anaa nea ɛboro saa a, nsusuw sɛ ɛyɛ LEMS. Nanso, sɛ saa sɛnkyerɛnne ahorow yi kɔ so a, nyansa wom sɛ wobɛhwehwɛ aduruyɛfo afotu.

Ɔkwan bɛn so na LEMS taa da adi na ɛkɔ so?

Mpɛn pii no LEMS di kan ka asen ntini ahorow . Afei ebetumi aka mmati ntini, nsa ne nan ntini, ntini a ɛboa ma ɔkasa ne ɔmene, ne aniwa ntini.

Yare no mfiase no, ebia ɛbɛyɛ den ama wo sɛ wobɛsɔre afi akongua so, aforo antweri anaa nkoko, anaa wobɛyɛ adwuma a emu yɛ den a ehia sɛ wode wo nan di dwuma.

Mpɛn pii no, sɛnkyerɛnne ahorow no ba nkakrankakra, wɔ adapɛn kakraa bi kosi asram pii mu . Nanso, sɛ wowɔ LEMS a kokoram wom a, ebia sɛnkyerɛnne ahorow no bɛda adi ntɛmntɛm.

Dɛn na ɛde LEMS ba?

Sɛnea yɛadi kan aka ho asɛm no, LEMS yɛ yare a nipadua no tumi ko tia nyarewa . Eyi kyerɛ sɛ wo nipadua no ankasa ahobammɔ (antibodies) tow hyɛ w’ankasa ntini a ɛte apɔw so. Wɔ LEMS mu no, saa nnuru a ɛko tia nyarewa yi tow hyɛ baabi a ntini mu nkwammoaa ne ntini mu nhama hyia, ntini mu ntini a ɛka bom no so. Ne titiriw no, wɔtow hyɛ calcium akwan a ɛwɔ hɔ no so. Saa calcium akwan yi ho hia na ama ntini mu nkrasɛm akɔ.

Fa no sɛ domino ahorow a ɛtoatoa so. Saa ntua yi de nsɛm a ɛtoatoa so ba:

1. Nkwammoaa a ɛko tia nyarewa no kyekyere calcium akwan a ɛwɔ ntini mu nkwammoaa no awiei no na esiw ano.

2. Sɛ wɔtew calcium akwan so a, acetylcholine a ɛyɛ ntini mu nkwaadɔm a ɛma mogya tu no so tew. Saa acetylcholine yi yɛ nnuru a ɛho hia ma ntini ahorow no dwumadi.

3. Sɛ acetylcholine nnɔɔso a, "nkrasɛm" a ɛkɔ ntini no mu no ntumi nkɔ yiye. Afei wo ntini ntumi nyɛ adwuma yiye.

4. Ne saa nti, ntini no ntumi nyɛ adwuma sɛnea ɛsɛ, na ɛde mmerɛwyɛ ba.

Sɛnea nnipa a wɔwɔ ahurututu mu kokoram a ɛwɔ nkwammoaa nketenkete mu no nya LEMS ni: Sɛ wowɔ kokoram wɔ wo nipadua mu a, nipadua mu nkwammoaa a ɛko tia nyarewa nya sɛnkyerɛnne bi a ɛkyerɛ sɛ "wɔkɔ ɔko." Nanso sɛ́ anka saa nnuru a ɛko tia nyarewa yi bɛtow ahyɛ kokoram nkwammoaa no so (titiriw, calcium akwan a ɛwɔ kokoram nkwammoaa no ani) no, wodi mfomso tow hyɛ calcium akwan a ɛwɔ ntini mu nkwammoaa no ano no so. Afei nsɛm a ɛtoatoa so koro no ara si.

Nyansahufo gye di sɛ nea ɛde LEMS ba nnipa a wonni ahurututu mu kokoram mu no yɛ nipadua no mu tumi a ɛko tia nyarewa no a entumi nyɛ adwuma yiye ara kwa. Nanso wonnya nhuu nea enti a eyi ba.

Ɔkwan bɛn so na wobetumi ahu `(LEMS)`?

Ade a edi kan a ɛsɛ sɛ woyɛ de hu LEMS ne sɛ wo duruyɛfo bɛhwɛ wo yiye. Mpɛn pii no, eyi bɛfa ntini ho ɔyaresafo, anaa oduruyɛfo a ne ho akokwaw wɔ ntini ne ntini mu nyarewa ho. Adeyɛ yi fã bi ne sɛ wubebisa wo yare no ho sɛnkyerɛnne, w’ayaresa ho abakɔsɛm, ne nnuru biara a wonom ho asɛm. Wɔyɛ ntini mu nhwehwɛmu a ɛkɔ akyiri de hwehwɛ mmerɛwyɛ ho nhyehyɛe ne sɛnkyerɛnne ahorow a ɛne LEMS hyia.

Ade a edi hɔ a ɛsɛ sɛ woyɛ ne sɔhwɛ. Sɔhwɛ ahorow a wɔde yɛ `(LEMS)` no bi ne:

• Mogya mu nhwehwɛmu: Eyi betumi ahwɛ sɛ wowɔ anti-calcium channel antibodies wɔ wo mogya mu anaa. Nnipa a wɔwɔ LEMS no mu bɛyɛ 85% wɔ saa nnuru a ɛko tia nyarewa yi wɔ wɔn mogya mu.
• Electromyography (EMG): Saa sɔhwɛ yi hwɛ sɛnea wo ntini ne wo ntini ahorow reyɛ adwuma yiye. Wɔ LEMS mu no, EMG sɔhwɛ no wɔ nsɛm pɔtee bi a wɔahu, enti ebetumi aboa ma wɔasi yare no so dua.
• Lung X-ray `(X-ray)` anaa CT scan `(CT scan)` anaa MRI scan `(MRI)` (of the chest): Esiane sɛ tebea bi a wɔfrɛ no `(LEMS)` betumi aba nnipa a wɔwɔ nkwammoaa nketenkete ahurututu mu kokoram mu nti, saa nhwehwɛmu ahorow yi hwehwɛ ahurututu mu kokoram ho sɛnkyerɛnne.

LEMS ho sɛnkyerɛnne betumi afi ase asram kosi mfe asia ansa na kokoram aba. Enti, sɛ wohu sɛ wowɔ LEMS wie a, ɛsɛ sɛ woyɛ kokoram ho nhwehwɛmu asram abiɛsa kosi asia biara anyɛ yiye koraa no mfe abien. Wo duruyɛfo bɛkamfo nhwehwɛmu nhyehyɛe a ɛfata ama wo akyerɛ wo.

Ɔkwan bɛn so na wɔsa LEMS yare?

Ayaresa ahorow pii wɔ hɔ a wɔde sa LEMS.

• Kokoram a ɛwɔ ase no a wɔbɛsa: Sɛ LEMS ne kokoram bi te sɛ ahurututu mu kokoram a nkwammoaa nketenkete wɔ abusuabɔ a, saa kokoram no a wɔbɛsa no nso betumi atew LEMS sɛnkyerɛnne ahorow so. Ebia kokoram ayaresa ahorow bi ne nnuru a wɔde sa yare, mframa a wɔde sa yare, ne/anaasɛ oprehyɛn. Eyi gyina kokoram ko ne wo duruyɛfo nyansahyɛ ahorow so.
• Ayaresa pɔtee a wɔde sa (LEMS): Eyinom bi ne nnuru a ɛma yare no ho sɛnkyerɛnne so tew ne nnuru a ɛhwɛ nipadua no mu tumi a ɛko tia nyarewa no so.

Ayaresa a wɔde sa yare no ho sɛnkyerɛnne ahorow

• Amifampridine (Firdapse®), Guanidine: Saa nnuru yi ma ntini ahoɔden yɛ kɛse. Wɔma ntini mu nkwaadɔm a ɛma ntini no yɛ adwuma acetylcholine a ɛba ntini mu ntini no hyia no yɛ kɛse, na ɛma nsɛnkyerɛnne a ɛkɔ ntini no mu no tu mpɔn.
• Pyridostigmine (Pyridostigmine - Mestinon®): Pyridostigmine yɛ adwuma denam acetylcholine a ɛpaapae wɔ neuromuscular junction a esiw ano no so. Eyi nso ma acetylcholine sɛnkyerɛnne yɛ kɛse na ɛma ntini ahoɔden tu mpɔn. Ɛtɔ mmere bi a wɔde pyridostigmine ka amifampridine ho ma ntini no dwumadi tu mpɔn na ɛsa LEMS ho sɛnkyerɛnne te sɛ ano a ɛyɛ mmerɛw, aniwa a ɛyɛ mmerɛw, akisikuru, nna mu ɔhaw, ne fifiri a ɛso tew. Nanso, pyridostigmine a wɔde di dwuma ma LEMS no yɛ ade a wɔmfa nni dwuma wɔ krataa so, a ɛkyerɛ sɛ U.S. Aduan ne Nnuru Dwumadibea (FDA) nmpene aduru no so mma tebea yi.

Ayaresa a ɛma nipadua no tumi ko tia nyarewa

• Nnuru a ɛma nipadua no tumi ko tia nyarewa:Saa nnuru yi boa ma wogyae anaasɛ wodi wo nipadua mu ahoɔden a ɛko tia nyarewa no "defense" dwumadi so. Ebia wo duruyɛfo bɛkyerɛw saa nnuru yi sɛ nnuru afoforo ntumi nni wo yare no ho sɛnkyerɛnne so a. Sɛ nhwɛso no, wobetumi de aduru bi a wɔfrɛ no prednisone ama azathioprine anaa cyclosporine anaasɛ wɔmfa nka ho.
• Plasma exchange: Wɔ saa adeyɛ yi mu no, afiri bi yi wo mogya no fã a ɛyɛ nsu (plasma) no fi mogya mu nkwammoaa no mu. Wo antibodies no wɔ saa plasma yi mu. Sɛ wɔtetew mu wie a, wɔsan de mogya no gu wo nipadua mu. Wo duruyɛfo betumi asusuw saa ayaresa yi ho sɛ wowɔ yare no ho sɛnkyerɛnne a emu yɛ den na wuhia ayaresa a egye ntɛmpɛ a.
• Immunoglobulins: Wɔ nnipa binom fam no, immunoglobulin dodow a ɛdɔɔso a wɔde sa yare no betumi aboa ma yare no ansɛe.

So wobetumi asiw LEMS ano?

Wonnya nte nea ɛde LEMS ba ankasa no ase yiye, enti wonnim sɛ ebia ɔkwan bi wɔ hɔ a wɔbɛfa so asiw yare no ano anaa.

Nanso esiane sɛ LEMS tumi nya nnipa a wɔwɔ ahurututu mu kokoram nti, wubetumi aboa ma wɔasiw ahurututu mu kokoram ano denam:

• Mma nnom sigaret. Sɛ wode tawa ho nneɛma di dwuma a, srɛ wo duruyɛfo ma ɔmmoa wo mma wogyae.
• Kwati wusiw a wɔde di dwuma dedaw.
• Hwɛ wo fie sɛ radon mframa anaa. Radon mframa a wode bedi dwuma bere tenten no betumi ama asiane a ɛwɔ hɔ sɛ wubenya ahurututu mu kokoram no ayɛ kɛse.

Wubetumi nso ayɛ nneɛma bi de akura asetra kwan a ahoɔden wom mu:

• Di nnuaba ne nhabannuru pii. Di Mediterranea anaa DASH aduan no akyi.
• Kura mu duru a ɛfata mu.
• Apɔw-mu-teɛteɛ sɛnea wo duruyɛfo de afotu ma no.
• Nya nna a ehia - mpɛn pii no nnɔnhwerew nson kosi akron.
• Tew w’adwennwen so. Adwennwen betumi ama yare no ho sɛnkyerɛnne no asɛe kɛse.
• Kwati sɛ wobɛguare wɔ nsu a ɛyɛ hyew mu. Ɔhyew betumi ama LEMS ho sɛnkyerɛnne no asɛe kɛse.
• Kɔ wo duruyɛfo nkyɛn daa, na sɛ w’akwahosan sesa anaa sɛ wunya yare no ho sɛnkyerɛnne foforo a, ma wɔnhu ntɛm ara.

So wobetumi asa LEMS yare koraa?

Nea ɛyɛ awerɛhow no, wonni aduru biara a wɔde sa LEMS. Wɔada no adi sɛ kokoram a ɛda adi a ɛbata LEMS ho a wɔsa no ma LEMS ho sɛnkyerɛnne tu mpɔn. Nnuru a ɛma nipadua no tumi ko tia nyarewa no betumi aboa ma wɔadi nipadua no tumi a ɛko tia nyarewa no ntua no so, na ayaresa ahorow nso wɔ hɔ a ebetumi aboa ma yare no ho sɛnkyerɛnne no afi hɔ denam acetylcholine dodow a wɔbɛma akɔ soro wɔ ntini ahorow no awiei na ama ntini ahoɔden atu mpɔn no so.

Sɛ wowɔ LEMS a kokoram nni mu a, wubetumi ahwɛ kwan sɛ wubenya nkwa nna a ɛfata. Sɛ wowɔ LEMS ne kokoram a, wo sɛnkyerɛnne betumi atu mpɔn bere tenten (ɛwom sɛ ɛnyɛ koraa de) sɛ wohu kokoram no na wodi ho dwuma ntɛm a.

W’asetra pa gyina sɛnea wo sɛnkyerɛnne ahorow no mu yɛ den so kɛse.

Bere bɛn na ɛsɛ sɛ me ne me duruyɛfo di nkitaho sɛ mewɔ `(LEMS)` a?

Sɛ nsakrae ba w’akwahosan mu, anaasɛ wo sɛnkyerɛnne no mu yɛ den a, kɔ wo duruyɛfo nkyɛn bere biara . Nsuro, mma wo ho nnyɛ wo hu. Nnuruyɛfo wɔ hɔ sɛ wɔbɛboa wo.

Nsonsonoe bɛn na ɛwɔ `(LEMS)` ne `(Myasthenia Gravis - MG)` ntam?

Lambert-Eaton myasthenic syndrome (LEMS) ne myasthenia gravis (MG) wɔ sɛnkyerɛnne ahorow bi a ɛte saa ara. N’abien nyinaa ma ntini ahorow yɛ mmerɛw na ɔbrɛ.

Nanso, mpɛn pii no, myasthenia gravis (MG) di kan ka ntini a atwa w’ani ho ahyia ne ntini a wɔde mene ade no. Akyiri yi, ebetumi aka ntini a ɛwɔ hɔ nyinaa, a ahome ntini ne akwaa ntini ka ho.

Mpɛn pii no, LEMS fi ase bere a w’asen atifi yɛ mmerɛw, afei ɛkɔ wo nsa so. LEMS nso betumi ama w’ani ntini ayɛ mmerɛw, nanso mpɛn pii no ɛyɛ mmerɛw sen myasthenia gravis (MG).

Wɔ myasthenia gravis (MG) mu no, ɔhome ntini (ntini a ɛboa wo ma wohome) a ɛyɛ mmerɛw kɛse no betumi akum obi. Eyi ho yɛ na wɔ LEMS mu.

Nnipa a wɔwɔ myasthenia gravis (MG) no ntaa nna autonomic nervous system dysfunction ho sɛnkyerɛnne pii adi (e.g., aniwa a ɛyɛ mmerɛw, ano a ɛyɛ mmerɛw, akisikuru, fifiri a ɛso tew, nna mu ɔhaw). Nea ɛne eyi bɔ abira no, nnipa a wɔwɔ LEMS taa nya saa anwiinwii yi, na ɛtɔ mmere bi a saa sɛnkyerɛnne ahorow yi betumi aboa ma wɔahu nsonsonoe a ɛda nyarewa abien no ntam.

Nea etwa to no, nneɛma a ɛsɛ sɛ wokae (Take-Home Message) .

Ebia ebedu saa bere yi no woate ase sɛ Lambert-Eaton Myasthenic Syndrome (LEMS) yɛ yare a nipadua no mu tumi a ɛko tia nyarewa a ɛyɛ adwuma boro so na ɛde ba. Wo ntini mu nkwammoaa no mfa nkrasɛm a ɛdɔɔso nkɔma wo ntini mu nhama no sɛnea ɛbɛyɛ a "ɛbɛtwetwe." Nea efi mu ba ne ntini a ɛyɛ mmerɛw ne sɛnkyerɛnne afoforo.

Kae sɛ, nnipa a wɔwɔ LEMS no mu bɛyɛ 60% wɔ ahurututu mu kokoram a ɛwɔ nkwammoaa nketenkete. Sɛ wowɔ LEMS nanso wunni kokoram a, hwɛ hu sɛ wo ne wo duruyɛfo no bɛyɛ kokoram nhwehwɛmu asram kakraa biara anyɛ yiye koraa no mfe abien wɔ bere a wɔahu sɛ wowɔ kokoram no akyi.

Ayaresa ahorow wɔ hɔ. Eyinom bi ne sɛ wɔbɛsa kokoram no sɛ ɛwɔ hɔ a, ne nnuru a wɔnom a ɛma ntini mu nkwammoaa ne ntini mu nhama nkitahodi tu mpɔn. Nkitahodi a ɛkɔ anim no betumi ama ntini ahoɔden ne sɛnkyerɛnne afoforo atu mpɔn.

Mewɔ anidaso sɛ saa nsɛm yi ho bɛba wo mfaso.Kae bere nyinaa sɛ, sɛ wowɔ akwahosan ho haw bi a, ɛbɛyɛ papa sɛ wo ne oduruyɛfo a ɔwɔ nimdeɛ bɛkasa afa ho.

` Lambert-Eaton myasthenic syndrome, LEMS, nyarewa a nipadua no tumi ko tia nyarewa, ntini mu mmerɛwyɛ, nkwammoaa nketenkete ahurututu mu kokoram, ntini mu ntini a ɛka bom, acetylcholine