This video illustrates muscle twitching (myokymia) in the calf of a 42-year-old man with psoriasis due to Isaacs syndrome, a syndrome of neuromyotonia (peripheral nerve hyperexcitability) that can be genetic, due to autoimmune disease, or be the manifestations of a paraneoplastic syndrome. This patient had voltage-gated potassium channel (VGKC)–complex antibodies against CASPR2 and LGI1, previously described in association with psoriasis, so the etiology was presumed to be autoimmune. The patien
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