Morvan syndrome with positive anti LGI1/CASPR2 antibodies in serum/cerebrospinal fluid:a case report and literature review / 中华内科杂志

To report a typical case of Morvan syndrome with positive anti-leucine rich glioma-inactivated 1(LGI1) and contactin-associated protein 2 (CASPR2) antibodies in serum and cerebrospinal fluid. A 39-years-old female initially presented weakness of extremeties. The main symptoms included paroxysmal limb pain, wheezing, itching, muscle twitching, epilepsy, hypomnesia, dysphoria, apathy, intractable insomnia, salivation and sweating. Tests of electrolytes found hypokalemia (2.7-3.1 mmol/L) and hyponatremia (130-136 mmol/L). Arterial blood gas analysis showed hypoxemia (oxygen saturation 50%-70%). Total thyroxine (TT4) was elevated to 207 nmol/L with positive thyroid peroxidase antibody (TPO-Ab) and thyroglobulin antibody (TG-Ab). LGI1and CASPR2 antibodies (CBA method) were positive in both serum and cerebrospinal fluid, and the remaining antibodies related to autoimmune encephalitis and paraneoplastic syndrome were negative. Head MRI was almost normal, while mild abnormalities were found in electroencephalogram. Electromyography showed slightly increased voltage of left quadriceps motor unit potential. After treated with corticosteroids, IVIG and mycophenolate mofetil, the patient completely improved. Cognitive function scores recovered from MoCA/MMSE (16/24) to MoCA/MMSE (26/29). Positivity of LGI1/CASPR2 antibodies both in serum/cerebrospinal fluid are rarely seen in patients with Morvan syndrome. Steroids and immunosuppressants are suggested for treatment as early as possible.

Efficacy and safety of solifenacin in the treatment of overactive bladder / 中华泌尿外科杂志

Objective To evaluate the efficacy and safety of solifenacin in patients with overactive bladder (OAB). Methods A multicenter clinical trial was conduced. 216 patients with OAB were enrolled. All the patients received solifenacin(5 mg once daily). With 5 weeks'treatment, all the patients recorded the diary and the adverse events as well. The symptoms of urgency, frequency, nocturia, urine volume, incontinence were evaluated. The results of the efficacy and safety were analyzed by using SPSS 13. 0. Results After 5 week treatments, all the index obviously improved(P<0.05). 187 cases (86.7%)were cured and 43 cases recovered normal voiding, 29 cases improved obviously. 11cases(5.0 %)reported adverse effect as dry mouth, dry eye. Conclusion Solifenacin could be the safe and effective drug in the treatment of OAB patients.