Neuromyotonia and myasthenia gravis without thymoma

Over the years, the symptoms had been fluctuating but for the past two months they had become debilitating. [...]the patient sought a second opinion. Complete blood count, serum creatinine, blood urea nitrogen, liver function tests, serum electrolytes, thyroid function tests, and serum creatine kinase were normal. Anti-VGKC antibodies are found in approximately 40% of patients with acquired neuromyotonia 2- 4 ; they are also found in patients with other neuromuscular hyperexcitability syndromes, such as cramp fasciculation syndrome, acquired rippling muscle syndrome, facial myokymia. 5, 6 In a significant proportion of these patients, coexistence of myasthenia gravis and neoplastic disorders, thymoma in particular, is observed. 4, 5 About 20% of all reported neuromyotonia patients had thymoma; 70% thereof also had myasthenia gravis and anti-AChR antibodies and 20% had anti-AChR antibodies without overt myasthenia gravis.