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Morvan's syndrome-is a pathogen behind the curtain?
Rohit Singh1, Pritam Das1, Upinder Kaur2
1Department of General Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
Summary
Morvan's syndrome, a rare autoimmune disorder, presents with nerve hyperexcitability and delirium. This study details four cases, suggesting potential infectious triggers for this rare neurological condition.
Area of Science:
- Neurology
- Immunology
- Rare Diseases
Background:
- Morvan's syndrome is a rare autoimmune disorder characterized by peripheral nerve hyperexcitability, dysautonomia, insomnia, and delirium.
- Fewer than 100 cases have been documented globally, highlighting its rarity.
Purpose of the Study:
- To describe a case series of Morvan's syndrome in North India.
- To investigate potential triggers and diagnostic features of this rare syndrome.
Main Methods:
- Retrospective case series analysis of four patients presenting with Morvan's syndrome.
- Clinical examination, electromyography (EMG), and serological testing for Anti-CASPR2 antibodies were performed.
Main Results:
- All four patients exhibited behavioral changes, sleep disturbances, hallucinations, autonomic dysfunction, and peripheral nerve hyperexcitability (myokymia).
- Two patients tested positive for Anti-CASPR2 antibodies; three showed EMG evidence of nerve hyperexcitability.
- Only one patient had elevated cerebrospinal fluid protein.
Conclusions:
- The study suggests a potential infectious trigger for Morvan's syndrome and related autoimmune neuropathies.
- The occurrence of four cases in a short period and limited area supports this hypothesis, warranting further investigation into viral triggers and autoantibody generation.
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