ACHE and myasthenia gravis: Therapeutic options for LEMS encompass 3,4-diaminopyridine (3,4-DAP) or 3,4-diaminopyridine phosphate (3,4-DAPP) as first-line options [24] as well as acetylcholinesterase inhibitors and immunosuppressive agents also commonly used in treatment of myasthenia gravis (MG) [35].