Cramp-fasciculation syndrome in patients with and without neural autoantibodies

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Introduction: We investigated the clinical, electrophysiological and neural autoantibody characteristics in cramp-fasciculation syndrome (CFS) patients. Methods: We reviewed Mayo Clinic records from 2000 to 2011 to identify clinically defined CFS patients who underwent neural autoantibody testing. Stored sera of patients who tested positive for antibodies to voltage-gated potassium channel complex (VGKC complex) were analyzed further for leucine-rich glioma-inactivated 1 (LGI1) or contactin-associated protein-2 immunoglobulin G (CASPR2-IgG) antibodies. Results: Thirty-seven patients were identified. Twelve were seropositive for neural autoantibodies. Clinical manifestations were similar in seropositive and seronegative patients, although central and autonomic neuronal hyperexcitability symptoms were more common in seropositive cases. No patients had a malignancy. Repetitive tibial nerve stimulation at 10 Hz revealed longer afterdischarges in seropositive patients. Two of 7 patients with VGKC-complex autoimmunity demonstrated LGI1 or CASPR2-IgG antibodies. Only 2 of 12 seropositive patients required immunotherapy. Conclusions: VGKC-complex autoimmunity occurs in a minority of CFS patients. Antibody positivity was associated with extramuscular manifestations, typically without malignancy. Target antigens within the VGKC complex remain unknown in most patients.

Original languageEnglish (US)
Pages (from-to)351-356
Number of pages6
JournalMuscle and Nerve
Volume49
Issue number3
DOIs
StatePublished - 2014

Fingerprint

Neuromuscular Diseases
Autoantibodies
Antibodies
Immunoglobulin G
Autoimmunity
Leucine
Glioma
Contactin 1
Voltage-Gated Potassium Channels
Tibial Nerve
Immunotherapy
Neoplasms

Keywords

  • CASPR2 antibody
  • Cramp-fasciculation syndrome
  • LGI1 antibody
  • Peripheral nerve hyperexcitability syndrome
  • Voltage-gated potassium channel complex antibody

ASJC Scopus subject areas

  • Clinical Neurology
  • Cellular and Molecular Neuroscience
  • Physiology (medical)
  • Physiology

Cite this

Cramp-fasciculation syndrome in patients with and without neural autoantibodies. / Liewluck, Teerin; Klein, Christopher Jon; Jones, Lyell.

In: Muscle and Nerve, Vol. 49, No. 3, 2014, p. 351-356.

Research output: Contribution to journalArticle

@article{b6d325133f6a43d3996d188074306c49,
title = "Cramp-fasciculation syndrome in patients with and without neural autoantibodies",
abstract = "Introduction: We investigated the clinical, electrophysiological and neural autoantibody characteristics in cramp-fasciculation syndrome (CFS) patients. Methods: We reviewed Mayo Clinic records from 2000 to 2011 to identify clinically defined CFS patients who underwent neural autoantibody testing. Stored sera of patients who tested positive for antibodies to voltage-gated potassium channel complex (VGKC complex) were analyzed further for leucine-rich glioma-inactivated 1 (LGI1) or contactin-associated protein-2 immunoglobulin G (CASPR2-IgG) antibodies. Results: Thirty-seven patients were identified. Twelve were seropositive for neural autoantibodies. Clinical manifestations were similar in seropositive and seronegative patients, although central and autonomic neuronal hyperexcitability symptoms were more common in seropositive cases. No patients had a malignancy. Repetitive tibial nerve stimulation at 10 Hz revealed longer afterdischarges in seropositive patients. Two of 7 patients with VGKC-complex autoimmunity demonstrated LGI1 or CASPR2-IgG antibodies. Only 2 of 12 seropositive patients required immunotherapy. Conclusions: VGKC-complex autoimmunity occurs in a minority of CFS patients. Antibody positivity was associated with extramuscular manifestations, typically without malignancy. Target antigens within the VGKC complex remain unknown in most patients.",
keywords = "CASPR2 antibody, Cramp-fasciculation syndrome, LGI1 antibody, Peripheral nerve hyperexcitability syndrome, Voltage-gated potassium channel complex antibody",
author = "Teerin Liewluck and Klein, {Christopher Jon} and Lyell Jones",
year = "2014",
doi = "10.1002/mus.23935",
language = "English (US)",
volume = "49",
pages = "351--356",
journal = "Muscle and Nerve",
issn = "0148-639X",
publisher = "John Wiley and Sons Inc.",
number = "3",

}

TY - JOUR

T1 - Cramp-fasciculation syndrome in patients with and without neural autoantibodies

AU - Liewluck, Teerin

AU - Klein, Christopher Jon

AU - Jones, Lyell

PY - 2014

Y1 - 2014

N2 - Introduction: We investigated the clinical, electrophysiological and neural autoantibody characteristics in cramp-fasciculation syndrome (CFS) patients. Methods: We reviewed Mayo Clinic records from 2000 to 2011 to identify clinically defined CFS patients who underwent neural autoantibody testing. Stored sera of patients who tested positive for antibodies to voltage-gated potassium channel complex (VGKC complex) were analyzed further for leucine-rich glioma-inactivated 1 (LGI1) or contactin-associated protein-2 immunoglobulin G (CASPR2-IgG) antibodies. Results: Thirty-seven patients were identified. Twelve were seropositive for neural autoantibodies. Clinical manifestations were similar in seropositive and seronegative patients, although central and autonomic neuronal hyperexcitability symptoms were more common in seropositive cases. No patients had a malignancy. Repetitive tibial nerve stimulation at 10 Hz revealed longer afterdischarges in seropositive patients. Two of 7 patients with VGKC-complex autoimmunity demonstrated LGI1 or CASPR2-IgG antibodies. Only 2 of 12 seropositive patients required immunotherapy. Conclusions: VGKC-complex autoimmunity occurs in a minority of CFS patients. Antibody positivity was associated with extramuscular manifestations, typically without malignancy. Target antigens within the VGKC complex remain unknown in most patients.

AB - Introduction: We investigated the clinical, electrophysiological and neural autoantibody characteristics in cramp-fasciculation syndrome (CFS) patients. Methods: We reviewed Mayo Clinic records from 2000 to 2011 to identify clinically defined CFS patients who underwent neural autoantibody testing. Stored sera of patients who tested positive for antibodies to voltage-gated potassium channel complex (VGKC complex) were analyzed further for leucine-rich glioma-inactivated 1 (LGI1) or contactin-associated protein-2 immunoglobulin G (CASPR2-IgG) antibodies. Results: Thirty-seven patients were identified. Twelve were seropositive for neural autoantibodies. Clinical manifestations were similar in seropositive and seronegative patients, although central and autonomic neuronal hyperexcitability symptoms were more common in seropositive cases. No patients had a malignancy. Repetitive tibial nerve stimulation at 10 Hz revealed longer afterdischarges in seropositive patients. Two of 7 patients with VGKC-complex autoimmunity demonstrated LGI1 or CASPR2-IgG antibodies. Only 2 of 12 seropositive patients required immunotherapy. Conclusions: VGKC-complex autoimmunity occurs in a minority of CFS patients. Antibody positivity was associated with extramuscular manifestations, typically without malignancy. Target antigens within the VGKC complex remain unknown in most patients.

KW - CASPR2 antibody

KW - Cramp-fasciculation syndrome

KW - LGI1 antibody

KW - Peripheral nerve hyperexcitability syndrome

KW - Voltage-gated potassium channel complex antibody

UR - http://www.scopus.com/inward/record.url?scp=84893966936&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84893966936&partnerID=8YFLogxK

U2 - 10.1002/mus.23935

DO - 10.1002/mus.23935

M3 - Article

VL - 49

SP - 351

EP - 356

JO - Muscle and Nerve

JF - Muscle and Nerve

SN - 0148-639X

IS - 3

ER -