To report a case of axonal sensory motor neuropathy with persistent high titers of binding and modulating acetylcholine receptor (AChR) and striational (Str) muscle antibodies (Ab).

 A 68-year-old man presented with progressive sensory complaints devloping over few years beginning in his feet including painful paresthesias and the sensation that his feet were swollen. His neurologic examination showed absence of vibratory sensibility in his toes, present although reduced at ankles. Pain and light touch were normal on his face and lower extremities and sensation was normal in his upper extremities. Over the next 8 years there was no progression in symptoms or changes in his examination. He’s never had complaints of weakness or motor symtoms or findings referable to his cranial nerves over subsequent followup.