Other conditions affecting neuromuscular transmission include Lambert-Eaton myasthenic syndrome (LEMS) (Titulaer et al., 2011), a range of congenital myasthenic syndromes (CMS) due to variants in > 30 different genes (e.g., CHRNE, RAPSN, DOK7, etc.)(Vanhaesebrouck and Beeson, 2019) and botulism (Guidon, 2019), all of which may be caused by various presynaptic, postsynaptic or combined mechanisms at the NMJ. This evidence concerns the gene RAPSN and congenital myasthenic syndrome.