Acquired neuromyotonia following upper respiratory tract infection: a case report

We present a 37-year-old male subject who presented with burning sensations in his hands and feet with generalised twitching of his limbs, trunk and face. His symptoms developed 2 weeks after an upper respiratory tract infection. There was associated facial flushing and disturbed night sleep but no memory impairment or generalised sweating. Examination showed generalised myokymia and fasciculations and electromyography revealed widespread continuous semi-rhythmic doublets and triplets of low frequency with interspersed silent periods. Anti voltage gated potassium channel antibodies, antinuclear antibodies, anti-acetylcholine receptor antibodies and the anti-neuronal antibodies anti Hu, anti Yo and anti Ri were all negative. His symptoms improved slightly on lamotrigine and amitriptyline.