Physician-assisted suicide and older patients'' perceived duty to die

The Lambert-Eaton syndrome is an autoimmune disease affecting the presynapse of the neuromuscular junction. Proximal muscle fatigue of the limbs is improved by repeated maximal voluntary contractions. Generally, patients present hypo or areflexia and frequently a dry mouth syndrome. In 50% of the cases, the Lambert-Eaton syndrome is associated with small-cell bronchogenic carcinoma. The different treatments proposed in the literature for Lambert-Eaton paraneoplastic syndrome focus on treatment of the primary tumor. Symptomatic treatment of the junctional disorder are based on cholinergic drugs, immunosuppression and immunomodulation, useful in case of unsuccessful antineoplastic therapy.