Rinsho Shinkeigaku (Clinical Neurology)

Brief Clinical Note

A case of anti VGKC-complex antibody associated disorder presenting with severe pain and fasciculations predominant in unilateral upper extremity

Kenju Hara, M.D.1), Osamu Watanabe, M.D.2), Ken Shibano, M.D.1) and Hideaki Ishiguro, M.D.1)

1)Department of Neurology, Akita Red Cross Hospital
2)Department of Neurology, and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences

A 21-year-old man complained of severe pain and muscle twitching localized in his right arm. Neurological examination showed muscle fasciculations in his right forearm but no myokymia or myotonia. Needle electromyography revealed fibrillation potentials in his biceps brachii muscle and extensor carpi radialis muscle at rest but no myokymic discharges. His serum anti-voltage-gated potassium channel (VGKC)-complex antibody level was significantly high (194.2 pM; controls <100 pM). Although anticonvulsant therapy relieved his pain, he was readmitted to our hospital because of severe pain in his left arm and both thighs three months later. A high-dose intravenous immunoglobulin (IVIG) therapy followed by steroid pulse therapy relieved his pain. This case with neither muscle cramp nor myokymia expands the phenotype of anti VGKC-complex antibody associated disorder.
Full Text of this Article in Japanese PDF (341K)

(CLINICA NEUROL, 52: 677|680, 2012)
key words: arm, pain, fasciculation, anti-VGKC complex antibody, steroid pulse therapy

(Received: 24-Nov-11)