Diagnosis confirmation can include specialist neurophysiology
A German review may include neurological examination, P/Q-type VGCC antibodies and repetitive nerve stimulation or EMG that documents the characteristic low CMAP and post-exercise or high-frequency increment. The budget is smaller when original high-quality antibody and electrophysiology results can be reviewed remotely before travel.
Tumor screening can be a major additional cost driver
The German S2k guideline recommends active tumor search because LEMS can precede small-cell lung cancer. Thoracic CT, selected FDG-PET/CT and risk-adapted repeat imaging can therefore become a separate diagnostic cost stream. If a tumor is detected, staging, biopsy and oncology treatment are not part of a simple neurology consultation price.
Amifampridine is an ongoing medication cost, not a one-time procedure
EU-authorised amifampridine is used for symptomatic treatment of adult LEMS. Initial specialist review can include dose titration, ECG or cardiac-risk review, renal/hepatic considerations and interaction checks. International patients should ask whether medication will be supplied in Germany or prescribed for continuation through their home-country system.
Selected immunotherapy adds infusion or monitoring costs
When symptomatic treatment is insufficient, a specialist may discuss IVIG or longer-term immunosuppression. Costs differ substantially between a short IVIG course and chronic immunosuppressive treatment with laboratory monitoring. These therapies should not be quoted before the diagnosis, tumor status and prior response are reviewed.
Paraneoplastic LEMS creates an integrated neurology-oncology budget
For LEMS associated with small-cell lung cancer or another malignancy, cancer treatment is central to management. Oncology consultation, staging, systemic therapy, radiotherapy and follow-up should be budgeted separately from neuromuscular symptom treatment.
Remote record review can prevent duplicated diagnostics
Send original electrophysiology and tumor-screening records before requesting a quote so the center can decide what genuinely needs repeating.
- P/Q-type VGCC and SOX1 antibody results
- Repetitive nerve stimulation / EMG reports with CMAP and increment data
- Thoracic CT and FDG-PET/CT images and reports
- Oncology records and smoking history
- Current amifampridine/Firdapse dose and response
- ECG and relevant cardiac history
- Previous IVIG or immunotherapy and response
- Exact request: diagnosis confirmation, treatment optimisation, tumor-screening plan or oncology-neurology second opinion
Official sources
Last source-reviewed 2026-09-02. Cost procedures and published service fees can change, so confirm current terms directly with the provider before transferring money or booking travel.