Supplementary appendixThis appendix formed part of the original submission and has been peer reviewed. We post it as supplied by the authors.

Supplement to: Vale TC, Pedroso JL, Dutra LA, et al. Morvan syndrome as a paraneoplastic disorder of thymoma with anti-CASPR2 antibodies. Lancet 2017; 389: 1367–68.

WEB-APPENDIX 1 LEGEND: Needle electromyographic features of peripheral nerve

hyperexcitability: (1) Top left: F-wave study after left tibial nerve recording. (2) Top right:

superimposed F-waves recordings. Note the prolonged afterdischarges suggestive of peripheral

nerve hyperexcitability. (3) Bottom: Spontaneous bursts of doublet discharges on routine

needle electromyography (right biceps femoris long head muscle).

WEB-APPENDIX 2 LEGEND: One-night basal video-polysomnography. 2A: Night

hypnogram demonstrating sleep fragmentation with poor sleep efficiency and instability of

sleep stages. 2B: Abnormal NREM sleep epoch, in which we observe a lack of the hallmarks

of stage 2 non-REM sleep (spindles and K complexes). 2C: Abnormal REM sleep epoch.

Emergence of REM sleep without atonia characterized by excessive transient muscle activity

(arrows) during REM on limb EMG. During video recording of the REM sleep stage, it was

not witnessed any visible movement or altered behavior. The polysomnography findings of

transient loss of REM sleep atonia had no correlation with the described episodes of abnormal

behaviors. LOC: left electrooculogram; ROC: right electrooculogram; THX: thoracic belt;

ABD: abdominal belt; LLEG: left leg electromyogram; RLEG: right leg electromyogram;

EKG: electrocardiograph (DII derivation); POS: position.

WEB-APPENDIX 3 LEGEND: Chest computed tomography scan shows a mass whose

pathological analysis disclosed a thymoma (arrow). (A) Ascending aorta; (B) descending aorta;

(C) pulmonary artery.