The expected benefit of amifampridine is better muscle strength and day-to-day function.
“Many people have improvements in muscle strength, walking ability, stamina, and performance of everyday activities,” AlQahtani says, adding that some people notice improvement in symptoms such as dry mouth.
If symptoms aren’t well managed or remain bothersome, the first step is usually making sure that the dose has been optimized within recommended safety limits, says AlQahtani.
If amifampridine is not tolerated or not available, pyridostigmine (Mestinon) may be considered, and it can also be added to amifampridine for extra symptom relief.
“Pyridostigmine slows the breakdown of acetylcholine at the neuromuscular junction, which can leave more of that chemical messenger available to help muscles contract,” says AlQahtani.
When LEMS is associated with cancer, treating the cancer is a central part of therapy and may also improve LEMS symptoms, he says.
