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- Title
Cold allodynia as the presenting symptom in a case of acquired neuromyotonia (Isaacs syndrome) with multiple autoantibodies.
- Authors
Goh, Khean-Jin; Abdullah, Suhailah; Won Fen Wong; Swan-Sim Yeap; Shahrizaila, Nortina; Chong-Tin Tan
- Abstract
We report a patient who presented with severe cold-induced allodynia and hyperhidrosis, and found to have acquired neuromyotonia (Isaacs syndrome) with high voltage-gated potassium channel (VGKC) antibody titre,positive contactin-associated protein 2 (CASPR2) and leucine-rich glioma-inactivated 1 (LGI1) antibodies. The patient also had positive anti-dsDNA and acetylcholine receptor (AChR) antibodies without clinical features of SLE or myasthenia gravis, suggesting a strong underlying autoimmune tendency. CT thorax showed no thymoma. Her symptoms improved with intravenous immunoglobulin infusion but recurred despite maintenance oral corticosteroids and carbamazepine. She has since been on regular IVIG infusions. Cold allodynia is an unusual presentation in acquired neuromyotonia.
- Subjects
ALLODYNIA; ISAACS syndrome; AUTOANTIBODIES; HYPERHIDROSIS; CHOLINERGIC receptors; ADRENOCORTICAL hormones; CARBAMAZEPINE
- Publication
Neurology Asia, 2014, Vol 19, Issue 4, p409
- ISSN
1823-6138
- Publication type
Case Study