Title: Isaacs Syndrome
Authors: Alex Rebello M.D, D.M1, Mohd. Asif, M.D2; Kumbha Dhanusha, M.D2; Bandi Haritha, M.D2, Nangadda Narmada M.D2, Ram Chandra Poudel M.D3
  1. Department of Neurology, All India Institute of Medical Sciences, Mangalagiri, India
  2. Department of General Medicine, All India Institute of Medical Sciences, Mangalagiri, India
  3. Department of Medicine, Nova Hospital, Nepal
Corresponding author: Dr. Ram Chandra Poudel M.D, Department of Medicine, Nova Hospital, Nepal
Email: imaginechandra@gmail.com
Consent: Written informed consent was obtained from the patient to publish this report in accordance with the journal’s patient consent policy.
Funding: Nil
Conflicts of interests: None
A 40-year-old gentleman presented with history of fatigue, low back ache and pulling sensation in both his lower limbs since one month. On examination, there was continuous twitching of muscles (myokymia) over his right upper back (video ). He had normal muscle power and brisk deep tendon reflexes. MRI spine did not show any significant abnormality except early cervical spondylotic changes. He was clinically suspected to have Isaacs syndrome. CASPR2 antibodies in blood were strongly positive and confirmed the diagnosis.1 He was given intravenous methylprednisolone and phenytoin. His symptoms were significantly reduced on follow up after a month.