Encephalopathy, Peripheral Neuropathy, Dysautonomia, Myasthenia gravis, Malignant Thymoma, and Antiacetylcholine Receptor Antibodies in the CSF

A 54-year-old man suffered from multiple neurologic disturbances (polyneuropathy, encephalopathy, dysautonomia) associated with myasthenia gravis and malignant thymoma. No morphological signs of inflammation were present in the brain and peripheral nerves. Antiacetylcholine receptor antibodies were present in the brain and peripheral nerves. Antiacetylcholine receptor antibodies were present in serum and in cerebrospinal fluid. The association of thymoma, myasthenia gravis, multiple neurologic syndromes, and antiacetylcholine receptor antibodies in serum and cerebrospinal fluid has not been reported as yet. We suggest that this clinical picture is related to a generalized cholinergic dysfunction.