Morning Report Pearls: Morvan’s Syndrome

Dan Maxwell presented a fascinating case of non-small cell lung cancer associated “Morvan’s Syndrome.” Here are some clinical pearls for this rare autoimmune condition:

  • Morvan’s is an autoimmune encephalitis characterized by  hallucinations, peripheral nerve hyperexcitability (neuromyotonia), hyper-hydrosis,  REM sleep disturbance  and other symptoms of autonomic dysfunction.
  • It stems from autoantibodies to voltage-gated potassium channels.
  • 30% of cases are paraneoplastic in nature (primarily lung and thymoma). Lung cancer in particular portends a worse prognosis.
  • Given the rarity of this condition little is known about the optimal treatment approach. Steroids, PLEX and azathioprine are typically used in some combination.

Please see a the following review article for further discussion of Morvan’s and other CNS paraneoplastic syndromes.