Morvan chorea and agrypnia excitata: when video-polysomnographic recording guides the diagnosis.
BACKGROUND
Morvan chorea is an antibody-mediated limbic encephalopathy characterized by severe insomnia, mental confusion, hallucinations, enacted dreams, hyperhidrosis, and neuromyotonia.


METHODS
In a 78 years old man presenting with progressive insomnia apathy and depression, a video-polysomnogram documented enacted dreams mimicking daily life activity (oneiric stupor). This finding led us to perform a search for serum antibodies to voltage-gated K+ channels, which was positive. A diagnosis of Morvan chorea was done. The patient underwent plasma exchange with complete resolution of the clinical picture.


CONCLUSIONS
Oneiric stupor may represent a useful precocious diagnostic marker in Morvan chorea.
Department of Neurological Sciences, University of Bologna, Bologna, Italy. federica.provini@unibo.it
Federica
F
Provini
Sara
S
Marconi
Marcello
M
Amadori
Pietro
P
Guaraldi
Giulia
G
Pierangeli
Pietro
P
Cortelli
Elio
E
Lugaresi
Pasquale
P
Montagna
Paolo
P
Tinuper
D000368:Aged; D003072:Cognition Disorders / Q000175:diagnosis / Q000503:physiopathology; D003937:Diagnosis, Differential; D006801:Humans; D008032:Limbic System / Q000503:physiopathology*; D008297:Male; D020385:Myokymia / Q000175:diagnosis* / Q000503:physiopathology*; D017286:Polysomnography; D012893:Sleep Wake Disorders / Q000175:diagnosis* / Q000503:physiopathology*; D014743:Videotape Recording