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December 08, 2015; 85 (23) Clinical/Scientific Notes

Peripheral small fiber dysfunction and neuropathic pain in patients with Morvan syndrome

Chloé Laurencin, Nathalie André-Obadia, Jean-Philippe Camdessanché, François Mauguière, Elodie Ong, Sandra Vukusic, Laure Peter-Derex, David Meyronet, Françoise Bouhour, Christophe Vial, François Ducray, Jérôme Honnorat, Philippe Petiot
First published September 23, 2015, DOI: https://doi.org/10.1212/WNL.0000000000002037
Chloé Laurencin
From Explorations Fonctionnelles Neurologiques (C.L., E.O., P.P.), Hôpital de la Croix Rousse, Hospices Civils de Lyon; Service de Neurologie Fonctionnelle et d'Epileptologie (N.A.-O., F.M., L.P.-D.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon; French Reference Center for Paraneoplastic Neurological Syndrome (J.-P.C., F.D., J.H.), Hospices Civils de Lyon, Hôpital Neurologique, Bron; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU de Saint Etienne; Lyon Neuroscience Research Center (J.-P.C., F.D., J.H.), INSERM U1028/CNRS UMR 5292, Lyon; Université de Lyon–Université Claude Bernard Lyon 1 (F.M., S.V., F.D., J.H.), Lyon; Service de Neurologie A (S.V.) and Service d'Electroneuromyographie et Pathologies Neuromusculaires (F.B., C.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon; and Service d'Anatomopathologie (D.M.), Groupement Hospitalier Est, Hospices Civils de Lyon, France.
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Nathalie André-Obadia
From Explorations Fonctionnelles Neurologiques (C.L., E.O., P.P.), Hôpital de la Croix Rousse, Hospices Civils de Lyon; Service de Neurologie Fonctionnelle et d'Epileptologie (N.A.-O., F.M., L.P.-D.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon; French Reference Center for Paraneoplastic Neurological Syndrome (J.-P.C., F.D., J.H.), Hospices Civils de Lyon, Hôpital Neurologique, Bron; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU de Saint Etienne; Lyon Neuroscience Research Center (J.-P.C., F.D., J.H.), INSERM U1028/CNRS UMR 5292, Lyon; Université de Lyon–Université Claude Bernard Lyon 1 (F.M., S.V., F.D., J.H.), Lyon; Service de Neurologie A (S.V.) and Service d'Electroneuromyographie et Pathologies Neuromusculaires (F.B., C.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon; and Service d'Anatomopathologie (D.M.), Groupement Hospitalier Est, Hospices Civils de Lyon, France.
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Jean-Philippe Camdessanché
From Explorations Fonctionnelles Neurologiques (C.L., E.O., P.P.), Hôpital de la Croix Rousse, Hospices Civils de Lyon; Service de Neurologie Fonctionnelle et d'Epileptologie (N.A.-O., F.M., L.P.-D.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon; French Reference Center for Paraneoplastic Neurological Syndrome (J.-P.C., F.D., J.H.), Hospices Civils de Lyon, Hôpital Neurologique, Bron; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU de Saint Etienne; Lyon Neuroscience Research Center (J.-P.C., F.D., J.H.), INSERM U1028/CNRS UMR 5292, Lyon; Université de Lyon–Université Claude Bernard Lyon 1 (F.M., S.V., F.D., J.H.), Lyon; Service de Neurologie A (S.V.) and Service d'Electroneuromyographie et Pathologies Neuromusculaires (F.B., C.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon; and Service d'Anatomopathologie (D.M.), Groupement Hospitalier Est, Hospices Civils de Lyon, France.
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François Mauguière
From Explorations Fonctionnelles Neurologiques (C.L., E.O., P.P.), Hôpital de la Croix Rousse, Hospices Civils de Lyon; Service de Neurologie Fonctionnelle et d'Epileptologie (N.A.-O., F.M., L.P.-D.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon; French Reference Center for Paraneoplastic Neurological Syndrome (J.-P.C., F.D., J.H.), Hospices Civils de Lyon, Hôpital Neurologique, Bron; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU de Saint Etienne; Lyon Neuroscience Research Center (J.-P.C., F.D., J.H.), INSERM U1028/CNRS UMR 5292, Lyon; Université de Lyon–Université Claude Bernard Lyon 1 (F.M., S.V., F.D., J.H.), Lyon; Service de Neurologie A (S.V.) and Service d'Electroneuromyographie et Pathologies Neuromusculaires (F.B., C.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon; and Service d'Anatomopathologie (D.M.), Groupement Hospitalier Est, Hospices Civils de Lyon, France.
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Elodie Ong
From Explorations Fonctionnelles Neurologiques (C.L., E.O., P.P.), Hôpital de la Croix Rousse, Hospices Civils de Lyon; Service de Neurologie Fonctionnelle et d'Epileptologie (N.A.-O., F.M., L.P.-D.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon; French Reference Center for Paraneoplastic Neurological Syndrome (J.-P.C., F.D., J.H.), Hospices Civils de Lyon, Hôpital Neurologique, Bron; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU de Saint Etienne; Lyon Neuroscience Research Center (J.-P.C., F.D., J.H.), INSERM U1028/CNRS UMR 5292, Lyon; Université de Lyon–Université Claude Bernard Lyon 1 (F.M., S.V., F.D., J.H.), Lyon; Service de Neurologie A (S.V.) and Service d'Electroneuromyographie et Pathologies Neuromusculaires (F.B., C.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon; and Service d'Anatomopathologie (D.M.), Groupement Hospitalier Est, Hospices Civils de Lyon, France.
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Sandra Vukusic
From Explorations Fonctionnelles Neurologiques (C.L., E.O., P.P.), Hôpital de la Croix Rousse, Hospices Civils de Lyon; Service de Neurologie Fonctionnelle et d'Epileptologie (N.A.-O., F.M., L.P.-D.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon; French Reference Center for Paraneoplastic Neurological Syndrome (J.-P.C., F.D., J.H.), Hospices Civils de Lyon, Hôpital Neurologique, Bron; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU de Saint Etienne; Lyon Neuroscience Research Center (J.-P.C., F.D., J.H.), INSERM U1028/CNRS UMR 5292, Lyon; Université de Lyon–Université Claude Bernard Lyon 1 (F.M., S.V., F.D., J.H.), Lyon; Service de Neurologie A (S.V.) and Service d'Electroneuromyographie et Pathologies Neuromusculaires (F.B., C.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon; and Service d'Anatomopathologie (D.M.), Groupement Hospitalier Est, Hospices Civils de Lyon, France.
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Laure Peter-Derex
From Explorations Fonctionnelles Neurologiques (C.L., E.O., P.P.), Hôpital de la Croix Rousse, Hospices Civils de Lyon; Service de Neurologie Fonctionnelle et d'Epileptologie (N.A.-O., F.M., L.P.-D.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon; French Reference Center for Paraneoplastic Neurological Syndrome (J.-P.C., F.D., J.H.), Hospices Civils de Lyon, Hôpital Neurologique, Bron; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU de Saint Etienne; Lyon Neuroscience Research Center (J.-P.C., F.D., J.H.), INSERM U1028/CNRS UMR 5292, Lyon; Université de Lyon–Université Claude Bernard Lyon 1 (F.M., S.V., F.D., J.H.), Lyon; Service de Neurologie A (S.V.) and Service d'Electroneuromyographie et Pathologies Neuromusculaires (F.B., C.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon; and Service d'Anatomopathologie (D.M.), Groupement Hospitalier Est, Hospices Civils de Lyon, France.
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David Meyronet
From Explorations Fonctionnelles Neurologiques (C.L., E.O., P.P.), Hôpital de la Croix Rousse, Hospices Civils de Lyon; Service de Neurologie Fonctionnelle et d'Epileptologie (N.A.-O., F.M., L.P.-D.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon; French Reference Center for Paraneoplastic Neurological Syndrome (J.-P.C., F.D., J.H.), Hospices Civils de Lyon, Hôpital Neurologique, Bron; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU de Saint Etienne; Lyon Neuroscience Research Center (J.-P.C., F.D., J.H.), INSERM U1028/CNRS UMR 5292, Lyon; Université de Lyon–Université Claude Bernard Lyon 1 (F.M., S.V., F.D., J.H.), Lyon; Service de Neurologie A (S.V.) and Service d'Electroneuromyographie et Pathologies Neuromusculaires (F.B., C.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon; and Service d'Anatomopathologie (D.M.), Groupement Hospitalier Est, Hospices Civils de Lyon, France.
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Françoise Bouhour
From Explorations Fonctionnelles Neurologiques (C.L., E.O., P.P.), Hôpital de la Croix Rousse, Hospices Civils de Lyon; Service de Neurologie Fonctionnelle et d'Epileptologie (N.A.-O., F.M., L.P.-D.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon; French Reference Center for Paraneoplastic Neurological Syndrome (J.-P.C., F.D., J.H.), Hospices Civils de Lyon, Hôpital Neurologique, Bron; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU de Saint Etienne; Lyon Neuroscience Research Center (J.-P.C., F.D., J.H.), INSERM U1028/CNRS UMR 5292, Lyon; Université de Lyon–Université Claude Bernard Lyon 1 (F.M., S.V., F.D., J.H.), Lyon; Service de Neurologie A (S.V.) and Service d'Electroneuromyographie et Pathologies Neuromusculaires (F.B., C.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon; and Service d'Anatomopathologie (D.M.), Groupement Hospitalier Est, Hospices Civils de Lyon, France.
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Christophe Vial
From Explorations Fonctionnelles Neurologiques (C.L., E.O., P.P.), Hôpital de la Croix Rousse, Hospices Civils de Lyon; Service de Neurologie Fonctionnelle et d'Epileptologie (N.A.-O., F.M., L.P.-D.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon; French Reference Center for Paraneoplastic Neurological Syndrome (J.-P.C., F.D., J.H.), Hospices Civils de Lyon, Hôpital Neurologique, Bron; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU de Saint Etienne; Lyon Neuroscience Research Center (J.-P.C., F.D., J.H.), INSERM U1028/CNRS UMR 5292, Lyon; Université de Lyon–Université Claude Bernard Lyon 1 (F.M., S.V., F.D., J.H.), Lyon; Service de Neurologie A (S.V.) and Service d'Electroneuromyographie et Pathologies Neuromusculaires (F.B., C.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon; and Service d'Anatomopathologie (D.M.), Groupement Hospitalier Est, Hospices Civils de Lyon, France.
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François Ducray
From Explorations Fonctionnelles Neurologiques (C.L., E.O., P.P.), Hôpital de la Croix Rousse, Hospices Civils de Lyon; Service de Neurologie Fonctionnelle et d'Epileptologie (N.A.-O., F.M., L.P.-D.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon; French Reference Center for Paraneoplastic Neurological Syndrome (J.-P.C., F.D., J.H.), Hospices Civils de Lyon, Hôpital Neurologique, Bron; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU de Saint Etienne; Lyon Neuroscience Research Center (J.-P.C., F.D., J.H.), INSERM U1028/CNRS UMR 5292, Lyon; Université de Lyon–Université Claude Bernard Lyon 1 (F.M., S.V., F.D., J.H.), Lyon; Service de Neurologie A (S.V.) and Service d'Electroneuromyographie et Pathologies Neuromusculaires (F.B., C.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon; and Service d'Anatomopathologie (D.M.), Groupement Hospitalier Est, Hospices Civils de Lyon, France.
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Jérôme Honnorat
From Explorations Fonctionnelles Neurologiques (C.L., E.O., P.P.), Hôpital de la Croix Rousse, Hospices Civils de Lyon; Service de Neurologie Fonctionnelle et d'Epileptologie (N.A.-O., F.M., L.P.-D.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon; French Reference Center for Paraneoplastic Neurological Syndrome (J.-P.C., F.D., J.H.), Hospices Civils de Lyon, Hôpital Neurologique, Bron; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU de Saint Etienne; Lyon Neuroscience Research Center (J.-P.C., F.D., J.H.), INSERM U1028/CNRS UMR 5292, Lyon; Université de Lyon–Université Claude Bernard Lyon 1 (F.M., S.V., F.D., J.H.), Lyon; Service de Neurologie A (S.V.) and Service d'Electroneuromyographie et Pathologies Neuromusculaires (F.B., C.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon; and Service d'Anatomopathologie (D.M.), Groupement Hospitalier Est, Hospices Civils de Lyon, France.
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Philippe Petiot
From Explorations Fonctionnelles Neurologiques (C.L., E.O., P.P.), Hôpital de la Croix Rousse, Hospices Civils de Lyon; Service de Neurologie Fonctionnelle et d'Epileptologie (N.A.-O., F.M., L.P.-D.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon; French Reference Center for Paraneoplastic Neurological Syndrome (J.-P.C., F.D., J.H.), Hospices Civils de Lyon, Hôpital Neurologique, Bron; Service de Neurologie (J.-P.C.), Hôpital Nord, CHU de Saint Etienne; Lyon Neuroscience Research Center (J.-P.C., F.D., J.H.), INSERM U1028/CNRS UMR 5292, Lyon; Université de Lyon–Université Claude Bernard Lyon 1 (F.M., S.V., F.D., J.H.), Lyon; Service de Neurologie A (S.V.) and Service d'Electroneuromyographie et Pathologies Neuromusculaires (F.B., C.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon; and Service d'Anatomopathologie (D.M.), Groupement Hospitalier Est, Hospices Civils de Lyon, France.
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Citation
Peripheral small fiber dysfunction and neuropathic pain in patients with Morvan syndrome
Chloé Laurencin, Nathalie André-Obadia, Jean-Philippe Camdessanché, François Mauguière, Elodie Ong, Sandra Vukusic, Laure Peter-Derex, David Meyronet, Françoise Bouhour, Christophe Vial, François Ducray, Jérôme Honnorat, Philippe Petiot
Neurology Dec 2015, 85 (23) 2076-2078; DOI: 10.1212/WNL.0000000000002037

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Morvan syndrome (MoS) is an autoimmune-mediated syndrome that is frequently associated with malignant thymoma and autoantibodies targeting contactin associated protein-like 2 (CASPR2-Abs). Neuropathic pain is a frequent clinical feature in MoS—encountered in 62% of patients1—but the pain mechanisms are unknown. We studied 4 patients with MoS who had neuropathic pain and investigated whether this pain could be due to a selective involvement of small nerve fibers. Written consent was obtained from all patients, and the study was approved by the institutional review board of the University Claude Bernard Lyon 1.

Footnotes

  • Supplemental data at Neurology.org

  • Author contributions: Chloé Laurencin: acquisition of data, analysis, interpretation of the data, drafting of the manuscript for intellectual content. Nathalie André-Obadia: analysis and interpretation, critical revision of the manuscript for important intellectual content. Jean-Philippe Camdessanché: acquisition of data, critical revision of the manuscript for important intellectual content. François Mauguière: critical revision of the manuscript for important intellectual content. Elodie Ong: acquisition of data. Sandra Vukusic: critical revision of the manuscript for important intellectual content. Laure Peter-Derex: acquisition of data, critical revision of the manuscript for important intellectual content. François Ducray: acquisition of data, critical revision of the manuscript for important intellectual content. Françoise Bouhour: acquisition of data, critical revision of the manuscript for important intellectual content. Christophe Vial: acquisition of data, critical revision of the manuscript for important intellectual content. David Meyronet: acquisition of data. Jérôme Honnorat: analysis and interpretation, critical revision of the manuscript for important intellectual content, study supervision. Philippe Petiot: analysis, interpretation of the data, drafting of the manuscript for intellectual content, study supervision, study concept and design.

  • Study funding: No targeted funding reported.

  • Disclosure: The authors report no disclosures relevant to the manuscript. Go to Neurology.org for full disclosures.

  • Received April 6, 2015.
  • Accepted in final form August 10, 2015.
  • © 2015 American Academy of Neurology
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