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Reduplicative paramnesia in Morvan's syndrome

Lynsee A Hudson1, Yvonne D Rollins, C Alan Anderson

  • 1Department of Neurology, University of Colorado School of Medicine, Denver, Colorado, USA.

Journal of the Neurological Sciences
|October 12, 2007
PubMed
Abstract

Insights

Reduplicative paramnesia (RP) can occur in Morvan's syndrome associated with voltage-gated potassium channel antibodies (VGKC abs). Immunotherapy, including IV immunoglobulin and corticosteroids, may improve RP and nervous system hyperexcitability.

Area of Science:

  • Neurology
  • Immunology

Background:

  • Morvan's syndrome involves peripheral nervous system hyperexcitability, including myokymia and neuromyotonia, often associated with VGKC abs.
  • Symptoms include hyperhydrosis, sleep disturbances, paresthesias, and encephalopathy.
  • Reduplicative paramnesia (RP) has not been previously reported in this condition.

Observation:

  • A 64-year-old male presented with a history of myokymia and myoclonus.
  • He experienced worsening parasomnia and confusion, developing a delusion of a duplicate home.
  • This presentation marked the first reported case of RP in Morvan's syndrome.

Findings:

  • Elevated serum VGKC antibody titers were detected.
  • Neuropsychological tests revealed executive function and memory deficits.
  • Electromyography confirmed diffuse myokymia. Treatment with IV immunoglobulin and prednisone improved RP and myoclonus, but not myokymia.

Implications:

  • RP is a potential neuropsychiatric manifestation of VGKC ab-associated Morvan's syndrome.
  • Both RP and nervous system hyperexcitability may respond to immunotherapy.
  • This case expands the understanding of Morvan's syndrome's clinical spectrum and treatment responses.

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