title: [Case of anti VGKC-complex antibody associated disorder presenting with severe pain and fasciculations predominant in unilateral upper extremity].
abstract: A 21-year-old man complained of severe pain and muscle twitching localized in his right arm. Neurological examination showed muscle fasciculations in his right forearm but no myokymia or myotonia. Needle electromyography revealed fibrillation potentials in his biceps brachii muscle and extensor carpi radialis muscle at rest but no myokymic discharges. His serum anti-voltage-gated potassium channel (VGKC)-complex antibody level was significantly high (194.2pM; controls <100pM). Although anticonvulsant therapy relieved his pain, he was readmitted to our hospital because of severe pain in his left arm and both thighs three months later. A high-dose intravenous immunoglobulin (IVIG) therapy followed by steroid pulse therapy relieved his pain. This case with neither muscle cramp nor myokymia expands the phenotype of anti VGKC-complex antibody associated disorder.
authors.affiliation: Department of Neurology, Akita Red Cross Hospital.
authors.forename: Kenju
authors.initials: K
authors.lastname: Hara
authors.forename: Osamu
authors.initials: O
authors.lastname: Watanabe
authors.forename: Ken
authors.initials: K
authors.lastname: Shibano
authors.forename: Hideaki
authors.initials: H
authors.lastname: Ishiguro
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D004576:Electromyography / Q000379:methods; D005207:Fasciculation / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage; D010146:Pain / Q000188:drug therapy* / Q000276:immunology*; D024642:Potassium Channels, Voltage-Gated / Q000276:immunology*; D020551:Pulse Therapy, Drug; D012720:Severity of Illness Index; D016896:Treatment Outcome; D034941:Upper Extremity; D055815:Young Adult
chemical_list: D001323:Autoantibodies; D015415:Biomarkers; D016756:Immunoglobulins, Intravenous; D024642:Potassium Channels, Voltage-Gated; D008775:Methylprednisolone