Editing Morvan's syndrome (section)

==Treatment==
In most of the reported cases, the treatment options were very similar.  [[Plasmapheresis]] alone or in combination with steroids, sometimes also with [[thymectomy]] and [[azathioprine]], have been the most frequently used therapeutic approach in treating Morvan's Syndrome. However, this does not always work, as failed response to steroids and to subsequently added plasmapheresis have been reported.  Intravenous immunoglobulin was effective in one case.<ref name=thymoma/>

In one case, the dramatic response to high-dose oral [[prednisolone]] together with pulse [[methylprednisolone]] with almost complete disappearance of the symptoms within a short period should induce consideration of corticosteroids.<ref name=thymoma/>

In another case, the subject was treated with [[haloperidol]] (6&nbsp;mg/day) with some improvement in the psychomotor agitation and hallucinations, but even high doses of [[carbamazepine]] given to the subject failed to improve the spontaneous muscle activity.  Plasma Exchange (PE) was initiated, and after the third such session, the itching, sweating, mental disturbances, and complex nocturnal behavior improved and these symptoms completely disappeared after the sixth session, with improvement in insomnia and reduced muscle twitching.  However, one month after the sixth PE session, there was a progressive worsening of insomnia and diurnal drowsiness, which promptly disappeared after another two PE sessions.<ref name=cardiac/>

In one case, high dose steroid treatment resulted in a transient improvement, but aggressive immuno-suppressive therapy with cyclophosphamide was necessary to control the disease and result in a dramatic clinical improvement.<ref name= "Spinazzi"/>

In another case, the subject was treated with prednisolone (1&nbsp;mg/kg body weight) with carbamazepine, [[propranolol]], and [[amitriptyline]].  After two weeks, improvement with decreased stiffness and spontaneous muscle activity and improved sleep was observed.  After another 7–10 days, the abnormal sleep behavior disappeared completely.<ref name=indian/>

In another case, symptomatic improvement with plasmapheresis, thymectomy, and chronic immunosuppression provide further support for an autoimmune or paraneoplastic basis.<ref name=paraneoplastic/>

Although thymectomy is believed to be a key element in the proposed treatment, there is a reported case of Morvan's Syndrome presenting itself post-thymectomy.<ref name=sub-acute/>