title: Atypical case of Morvan's syndrome.
abstract: Morvan's syndrome is a rare neurological condition characterized by the combination of neuromyotonia, autonomic instability and encephalopathy, associated with auto-antibodies against voltage-gated potassium channels. We report a patient with an initial presentation suggestive of typical Guillain-Barré syndrome (GBS), who later developed clinical and laboratory features compatible with Morvan's syndrome. Several months after resolution of the neurological symptoms, as well as disappearance of the characteristic anti-leucine-rich, glioma inactivated 1 (anti-LGI1) antibodies, the patient presented with episodes of fever of unknown origin, during which the antibodies became positive again, suggesting the possibility of a relapse. In this case, both the GBS-like symptoms at presentation and the isolated episodes of fever of unknown origin during follow-up are atypical, and may suggest the presence of an additional, yet unknown antibody.
authors.affiliation: Department of Neurology, Rabin Medical Center, Beilinson Campus 49100, Petach Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: itayl@clalit.org.il.
authors.forename: Itay
authors.initials: I
authors.lastname: Lotan
authors.affiliation: Department of Neurology, Rabin Medical Center, Beilinson Campus 49100, Petach Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Ruth
authors.initials: R
authors.lastname: Djaldetti
authors.affiliation: Department of Neurology, Rabin Medical Center, Beilinson Campus 49100, Petach Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Hellman
authors.affiliation: Department of Neurology, Rabin Medical Center, Beilinson Campus 49100, Petach Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Felix
authors.initials: F
authors.lastname: Benninger
mesh_terms: D001323:Autoantibodies / Q000097:blood*; D001324:Autoantigens / Q000276:immunology; D003937:Diagnosis, Differential; D020275:Guillain-Barre Syndrome / Q000175:diagnosis; D006801:Humans; D020386:Isaacs Syndrome / Q000175:diagnosis* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D024642:Potassium Channels, Voltage-Gated / Q000276:immunology
chemical_list: D001323:Autoantibodies; D001324:Autoantigens; D024642:Potassium Channels, Voltage-Gated
keywords: Guillain–Barré’ syndrome; Morvan’s syndrome; Paraneoplastic syndrome; Peripheral neuropathy