LGI1 and CASPR2-related Morvan syndrome - diagnostic challenges in a pediatric case

Abstract

Morvan syndrome is a rare immune-mediated pathology involving the central, peripheral and autonomic nervous systems. Although it was described in adults, mostly as a paraneoplastic syndrome, it is rarely seen in pediatric patients. In this report, we present the case of a 15-year-old male patient who experienced insomnia, peripheral nerve hyperexcitability and autonomic signs, highly suggestive for Morvan syndrome, but prone to diagnostic dilemmas as well. The diagnosis was confirmed by the presence of antibodies against voltage-gated potassium channels (VGKC). This article aims to highlight the unique clinical picture of a rare syndrome, diagnostic pitfalls and treatment options in pediatric patients.