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Dramatic improvement of neuromyotonia (Isaacs' syndrome) with THC in a case report
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According to a case report from a hospital in Nantes, France, oral
THC (dronabinol) improved the symptoms of a patient with Isaacs'
syndrome, which did not respond to other treatments. A 56-year-old
man presented with episodes of profuse sweating associated with
muscular twitching that began one year before the first assessment in
the hospital. Bouts of drenching sweats occurred 2 or 3 times a day,
lasted from 20 minutes to 2 hours and were associated with intense
itching on body truck. Body weight had decreased from 70 to 55 kg
during that period. He presented with prominent generalized myokymia,
i.e. involuntary, spontaneous, localized quivering of a few muscles
bundles within a muscle. Antibodies to transmembrane channels
specific for potassium were highly increased. Several medications and
treatments, including intravenous immunoglobulins, were tried to
reduce symptoms, but were all ineffective. Finally, THC was titrated
up progressively to 20 mg/day over a one month period and used as a
monotherapy.
Three months after the initiation of the treatment, the patient
started to improve. After one year, myokymia completely disappeared,
there were no longer any sweating attacks and body weight increased
to 65 kg. In addition, antibodies to potassium channels were normal.
Authors noted that "the dramatic improvement lasted for the last 2
years and is still ongoing." Isaacs' syndrome, also called
neuromyotomia or continuous muscle fibre activity, is a peripheral
motor nerve hyperactivity disorder. It is usually regarded as an
autoimmune disease caused by antibodies against neuromuscular
junction, resulting in an increase in neurotransmitter release.
Authors think that "the mechanism of action of dronabinol was rather
immunomodulatory than symptomatic."
(Source: Meyniel C, Ollivier Y, Hamidou M, Péréon Y, Derkinderen P.
Dramatic improvement of refractory Isaacs' syndrome after treatment
with dronabinol. Clin Neurol Neurosurg. 2010 Dec 6. [in press])
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