Reduplicative paramnesia in Morvan's syndrome.
BACKGROUND
Morvan's syndrome is characterized by peripheral nervous system hyperexcitibility (myokymia and neuromyotonia), hyperhydrosis, sleep disorder, limb paresthesias, and encephalopathy. Voltage gated potassium channel antibodies (VGKC abs) are frequently present. Reduplicative paramnesia (RP) has not been reported with this disorder.


OBJECTIVE
To describe a patient with Morvan's syndrome presenting with RP.


METHODS
Single case study.


METHODS
A 64-year-old man with several years of myokymia and myoclonus with escalating parasomnia and confusion developed the delusion that a replica of his house and its contents existed 40 mi away.


RESULTS
Serum VGKC ab titer was elevated. Neuropsychological testing disclosed executive function and memory deficits. Electromyography demonstrated diffuse myokymia. Treatment with intravenous immunoglobulin and prednisone produced improvement of RP and myoclonus, but not myokymia.


CONCLUSIONS
RP may occur in patients with VGKC ab-associated Morvan's syndrome. Both RP and nervous system hyperexcitability may respond to immunotherapy including intravenous immunoglobulin and corticosteroids.
Hudson
Lynsee A
LA
Department of Neurology, University of Colorado School of Medicine, Denver, Colorado, USA.
Rollins
Yvonne D
YD
Anderson
C Alan
CA
Johnston-Brooks
Catharine
C
Tyler
Kenneth L
KL
Filley
Christopher M
CM
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001323:Autoantibodies / Q000097:blood; D003072:Cognition Disorders / Q000188:drug therapy / Q000235:genetics / Q000276:immunology; D004576:Electromyography; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007167:Immunotherapy / Q000379:methods; D020386:Isaacs Syndrome / Q000235:genetics / Q000276:immunology / Q000503:physiopathology; D008297:Male; D008569:Memory Disorders / Q000188:drug therapy / Q000235:genetics / Q000276:immunology; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000276:immunology / Q000503:physiopathology; D020385:Myokymia / Q000150:complications* / Q000503:physiopathology / Q000523:psychology*; D009483:Neuropsychological Tests; D010525:Peripheral Nerves / Q000276:immunology / Q000503:physiopathology; D024642:Potassium Channels, Voltage-Gated / Q000276:immunology*; D011241:Prednisone / Q000627:therapeutic use; D012563:Schizophrenia, Paranoid / Q000188:drug therapy / Q000235:genetics* / Q000276:immunology*; D013577:Syndrome; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D001323:Autoantibodies; D016756:Immunoglobulins, Intravenous; D024642:Potassium Channels, Voltage-Gated; D011241:Prednisone