title: Isolated dysphagia as initial sign of anti-IgLON5 syndrome.
abstract: OBJECTIVE
  To report on dysphagia as initial sign in a case of anti-IgLON5 syndrome and provide an overview of the current literature.
  
  
  METHODS
  The diagnostic workup included cerebral MRI, fiber optic endoscopic evaluation of swallowing (FEES) with the FEES tensilon test, a videofluoroscopic swallowing study, evoked potentials and peripheral nerve conduction studies, polysomnography, lumbar puncture, and screening for neural autoantibodies. A systematic review of all published cases of IgLON5 syndrome is provided.
  
  
  RESULTS
  We report a case of anti-IgLON5 syndrome presenting with slowly progressive neurogenic dysphagia. FEES revealed severe neurogenic dysphagia and bilateral palsy of the vocal cords. Autoantibody screening was positive for IgLON5 IgG (+++, 1:1,000) serum levels but no other known neural autoantibody. Polysomnography was highly suggestive of non-REM parasomnia. Symptoms were partially responsive to immunotherapy.
  
  
  CONCLUSIONS
  Slowly progressive neurogenic dysphagia may occur as initial sign of anti-IgLON5 syndrome highlighting another clinical presentation of this rare disease.
authors.affiliation: Division of Sleep Medicine and Neuromuscular Disorders (A.H.), Department of Neurology (J.B.S., N.M., T.R., A.H., I.K., R.D., P.M., T.W., R.D.), University of Münster, Germany.
authors.forename: Jens Burchard
authors.initials: JB
authors.lastname: Schröder
authors.affiliation: Division of Sleep Medicine and Neuromuscular Disorders (A.H.), Department of Neurology (J.B.S., N.M., T.R., A.H., I.K., R.D., P.M., T.W., R.D.), University of Münster, Germany.
authors.forename: Nico
authors.initials: N
authors.lastname: Melzer
authors.affiliation: Division of Sleep Medicine and Neuromuscular Disorders (A.H.), Department of Neurology (J.B.S., N.M., T.R., A.H., I.K., R.D., P.M., T.W., R.D.), University of Münster, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Ruck
authors.affiliation: Division of Sleep Medicine and Neuromuscular Disorders (A.H.), Department of Neurology (J.B.S., N.M., T.R., A.H., I.K., R.D., P.M., T.W., R.D.), University of Münster, Germany.
authors.forename: Anna
authors.initials: A
authors.lastname: Heidbreder
authors.affiliation: Division of Sleep Medicine and Neuromuscular Disorders (A.H.), Department of Neurology (J.B.S., N.M., T.R., A.H., I.K., R.D., P.M., T.W., R.D.), University of Münster, Germany.
authors.forename: Ilka
authors.initials: I
authors.lastname: Kleffner
authors.affiliation: Division of Sleep Medicine and Neuromuscular Disorders (A.H.), Department of Neurology (J.B.S., N.M., T.R., A.H., I.K., R.D., P.M., T.W., R.D.), University of Münster, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Dittrich
authors.affiliation: Division of Sleep Medicine and Neuromuscular Disorders (A.H.), Department of Neurology (J.B.S., N.M., T.R., A.H., I.K., R.D., P.M., T.W., R.D.), University of Münster, Germany.
authors.forename: Paul
authors.initials: P
authors.lastname: Muhle
authors.affiliation: Division of Sleep Medicine and Neuromuscular Disorders (A.H.), Department of Neurology (J.B.S., N.M., T.R., A.H., I.K., R.D., P.M., T.W., R.D.), University of Münster, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Warnecke
authors.affiliation: Division of Sleep Medicine and Neuromuscular Disorders (A.H.), Department of Neurology (J.B.S., N.M., T.R., A.H., I.K., R.D., P.M., T.W., R.D.), University of Münster, Germany.
authors.forename: Rainer
authors.initials: R
authors.lastname: Dziewas