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July 1982

Generalized Myokymia and Gold Therapy

Author Affiliations

From the Departments of Neurology, Division of Neuromuscular Diseases, Case Western Reserve University and Veterans Administration Medical Center, Cleveland (Dr Mitsumoto), Cleveland Clinic Foundation (Dr Wilbourn), and the University of Mississippi Medical Center, Jackson (Dr Subramony).

Arch Neurol. 1982;39(7):449-450. doi:10.1001/archneur.1982.00510190067026

In 1934, Chavany and Chaignot reported an unusual syndrome that developed in a patient undergoing gold therapy and consisted of continuous vermicular twitching of muscles, like a "keyboard motion of the piano being rapidly played," excessive sweating, insomnia, and other mental symptoms.1 They called it "chorée fibrillaire de Morvan," after Morvan who apparently had first described this complex of symptoms.1 This unusual condition has been reported almost exclusively in French medical literature and has been associated primarily with gold therapy and rarely with inorganic mercury intoxication.2-4 We found no reports of such cases occurring in the United States.

REPORT OF A CASE  A 30-year-old man with rheumatoid arthritis of recent onset was receiving 50-mg injections of gold sodium thiomalate twice a week. After he had received a total dose of 1,200 mg, he began to experience fatigue, pruritus, sweating, irritability, emotional lability, and insomnia, along with generalized

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