Background: Neuromyotonia is a disorder of peripheral nerve hyperexcitability, causing spontaneous muscular activity. It is an extremely rare disease. Infrequency with which it is encountered and nonspecific, vague symptoms in young people make it a formidable diagnostic challenge.
Case description: We present a case of a 34-year-old male with complaints of twitching in muscles and pain in the thigh and calf region. These complaints occurred on and off since the last 6 months. He has a positive family history of similar symptoms. The patient was positive for serum voltage gated potassium channels (VGKC) antibodies. Electromyography (EMG) studies showed evidence of neuromyotonia. A diagnosis of Morvan's syndrome (neuromyotonia) was made on the basis of symptoms and EMG findings. The treatment of the patient was started on intravenous steroids, antiepileptics, and SSRI.
Conclusion: Diagnosis of neuromyotonia is a challenge. Awareness among people is important to mitigate the symptoms and provide timely management.
Harrison AR, Wirtschafter JD. Ocular neuromyotonia in a patient with cavernous sinus thrombosis secondary to mucormycosis. Am J Ophthalmol 1997;124:122–123. DOI: 10.1016/s0002-9394(14)71663-0.
Misra UK, Kalita J, et al. Neuromyotonia with neuropathy and muscle hypertrophy: association or cause? Electromyogr Clin Neurophysiol 2006;46:17–20.
Hahn AF, Parkes AW, et al. Neuromyotonia in hereditary motor neuropathy. J Neurol Neurosurg Psychiatry 1991;54:230–235. DOI: 10.1136/jnnp.54.3.230.
Vincent A, Buckley C, et al. Potassium channel antibody-associated encephalopathy: a potentially immunotherapy-responsive form of limbic encephalitis. Brain 2004;127:701–712. DOI: 10.1093/brain/awh077.