What are the referral criteria for a patient suspected of having LEMS to a neurologist?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 22 August 2025Updated: 22 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Referral criteria for a patient suspected of having Lambert-Eaton myasthenic syndrome (LEMS) to a neurologist:

  • Refer adults with slowly progressive limb weakness for assessment of neuromuscular disorders, which includes conditions like LEMS.
  • Urgently refer if there is any evidence of swallowing impairment.
  • Immediately refer if there is breathlessness at rest or when lying flat, as respiratory involvement may indicate severity.
  • Specify the possible diagnosis in the referral letter to the neurologist to facilitate appropriate assessment.
  • Contact the consultant neurologist directly if urgent assessment is needed.

These criteria align with the general recommendations for referral of neuromuscular disorders and progressive limb weakness to neurology services.

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