Functional imaging correlates of fronto-temporal dysfunction in Morvan's syndrome

A previously well 66 year old man presented with a one month history of focal involuntary spasms of his arms and then his left leg, culminating in two generalized convulsions. He also complained of episodic memory problems, sleeping difficulties, daytime somnolence, hyperphagia, hyperhidrosis and erectile impotence. He was treated initially with phenytoin for two months and then valproate. His family noticed increasing dishevelment and emotional lability over the previous six months. His step-daughter reported that he did not drink to excess although 10 years previously, there was heavy alcohol use.