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The Lambert-Eaton myasthenic syndrome (LEMS) is an autoimmune disorder affecting the peripheral nervous system, characterised by proximal muscle weakness and autonomic dysfunction. Approximately 60% of patients have an associated small cell lung carcinoma (SCLC). LEMS is the most studied of the paraneoplastic neurological syndromes. Approximately 90% of patients have autoantibodies to voltage-gated calcium channels (VGCCs), transmembrane proteins found on the presynaptic nerve terminal, in the cerebellum and on the surface of the SCLC. It has been postulated that antibodies raised against determinants on the tumour may cross-react with the VGCC at the nerve terminal resulting in the neurological dysfunction.