Morvan syndrome as a paraneoplastic disorder of thymoma with anti-CASPR2 antibodies

A 65-year-old right-handed businessman presented with a 3-month history of worsening muscle twitching and painful proximal muscle spasms, excessive sweating, constipation, cold hands, and a burning sensation in his feet. He had lost 10 kg and his wife reported that he seemed to have hallucinations during sleep. He had no relevant family or alcohol history, and was an ex-smoker with a 10 pack-year history.