A 55-year-old heavy smoker undergoes a neurological exam. Initially, he has a complete absence of deep tendon reflexes. However, after 30 minutes, the deep tendon reflex returns after he performs squats. What is the likely diagnosis?
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Doi sign is a clinic sign where previously absent deep tendon reflexes are observed after a short period of maximal muscle contraction.
This sign is seen in patients with Eaton-Lambert syndrome.
It is not seen in patients with neuropathy.
With Lambert sign, strength improves further with repeated testing; for example, improvement of power on repeated hand grip. At rest, reflexes are typically reduced; with muscle use, reflex strength increases. This is a characteristic feature. The pupillary light reflex may also be sluggish.
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