Opsoclonus myoclonus ataxia syndrome in severe acute respiratory syndrome coronavirus-2

Journal of NeuroVirology - A patient presented with an opsoclonus-myoclonus-ataxia syndrome after a 2-week period of fever. In her work as an assistant nurse, she had been exposed to patients...     

Opsoclonus in organophosphate poisoning

Transient opsoclonus was observed in a patient who attempted suicide with the organophosphate insecticide Malathion (diethyl[dimethoxyphosphinothioyl]thiobutanedioate). Several toxins can cause opsoclonus, and these must be considered in its differential diagnosis. Eye movement disorders are one of the more common manifestations of organophosphate intoxication, and opsoclonus should now be included among these. Acetylcholine may be a neurotransmitter in the ocular motor pathway.     

Opsoclonus: Its clinical value.

Although the exact site of pathologic involvement and the pathogenesis remain uncertain, opsoclonus is an invaluable clinical sign that in it alone may herald an occult systemic malignancy. A thorough systematic evaluation should be undertaken to exclude an occult neoplasm in any patient who presents with opsoclonus unaccompanied by any other clinical sign.     

Opsoclonus associated with multisystemic sarcoidosis]

A 32 year old patient with unexplained cough developed an opsoclonus-ataxic-myoclonic syndrome. Chest X-ray film were normal at this onset but became pathologic, and the diagnosis of multisystemic sarcoidosis was made. The possibility of sarcoidosis being the cause of the opsoclonus is discussed.     

Opsoclonus secondary to encephalopolyradiculoneuritis due to Mycoplasma pneumoniae

Opsoclonus is characterized by sudden onset of arrhythmic, multidirectional chaotic eye movements, generally associated with a parainfectious or paraneoplasic condition. Opsoclonus is a rare manifestation with no known link with infection by Mycoplasma pneumoniae. We present a case of a 23 year old male patient who presented fever, myalgia, vomiting, respiratory failure, opsoclonus and symmetric flaccid tetraparesis with important lower limb muscle atrophy. Serology and seroreversion for M. pneumoniae were both positive. This case illustrates the possibility that M. pneumoniae may produce a predominantly neurological disease and the need to include this infection in the differential diagnosis of opsoclonus, or polyradiculoneuritis.     

Opsoclonus in a patient with cerebellar dysfunction.

After two days of malaise, headache, nausea, and vomiting, a 26-year-old man suddenly developed opsoclonus and stance and gait ataxia, without myoclonus. Having excluded a paraneoplastic etiology, we assumed that the disorder was probably related to a viral infection. Spontaneous resolution occurred in about two months. Opsoclonus became flutter dysmetria and then resolved. Saccadic eye movement recording disclosed the occurrence of hypermetria, increased velocity, and delayed latency, which also resolved. In this patient, the correspondence between clinical and ocular motor abnormality courses suggests a transient cerebellar dysfunction as the possible pathophysiologic mechanism for opsoclonus.     

Opsoclonus persisting during sleep in West Nile encephalitis

BACKGROUND: Recent outbreaks of West Nile virus infection have alerted the public to disabling paralysis as an outcome. Ocular motor involvement with West Nile virus is rare. OBJECTIVE: To describe a patient with West Nile virus encephalitis that resulted in opsoclonus-myoclonus syndrome with persistent ocular oscillation on electroencephalography during stage 2 sleep. PATIENT: A 53-year-old man who presented with viral prodrome followed by intense vertigo and encephalopathy. In addition to multifocal myoclonic jerks in the extremities, his eye movements were disrupted by bursts of high-frequency, conjugate ocular oscillations that occurred in random directions. RESULTS: Electroencephalography showed eye movement artifacts during the awake state and stage 2 sleep. Opsoclonus-myoclonus syndrome remained disabling 3 months after onset but markedly improved 8 months after onset. CONCLUSIONS: West Nile virus is another cause of opsoclonus-myoclonus syndrome that can occur in conjunction with encephalitis. The presence of an eye movement artifact on results of electroencephalography during stage 2 sleep should raise suspicion for opsoclonus.