Morvan chorea and agrypnia excitata: when video-polysomnographic recording guides the diagnosis

Sleep Med. 2011 Dec;12(10):1041-3. doi: 10.1016/j.sleep.2011.05.005. Epub 2011 Oct 26.

Abstract

Introduction: Morvan chorea is an antibody-mediated limbic encephalopathy characterized by severe insomnia, mental confusion, hallucinations, enacted dreams, hyperhidrosis, and neuromyotonia.

Case description: In a 78 years old man presenting with progressive insomnia apathy and depression, a video-polysomnogram documented enacted dreams mimicking daily life activity (oneiric stupor). This finding led us to perform a search for serum antibodies to voltage-gated K+ channels, which was positive. A diagnosis of Morvan chorea was done. The patient underwent plasma exchange with complete resolution of the clinical picture.

Conclusions: Oneiric stupor may represent a useful precocious diagnostic marker in Morvan chorea.

Publication types

  • Case Reports
  • Video-Audio Media

MeSH terms

  • Aged
  • Cognition Disorders / diagnosis
  • Cognition Disorders / physiopathology
  • Diagnosis, Differential
  • Humans
  • Limbic System / physiopathology*
  • Male
  • Myokymia / diagnosis*
  • Myokymia / physiopathology*
  • Polysomnography*
  • Sleep Wake Disorders / diagnosis*
  • Sleep Wake Disorders / physiopathology*
  • Videotape Recording