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1.
Oh S-Y, Kim J-S, Dieterich M, 2019. Update on opsoclonus-myoclonus syndrome in adults. J Neurol 266: 1541–1548.
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2.
Auconi M, Papetti L, Ruscitto C, Ferilli MAN, Ursitti F, Sforza G, Vigevano F, Valeriani M, 2021. Opsoclonus-myoclonus syndrome in children and adolescents: A therapeutic challenge. Children 8: 965.
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3.
Gilchrist H, Patterson JW, 2010. Erythema nodosum and erythema induratum (nodular vasculitis): Diagnosis and management. Dermatol Ther 23: 320–327.
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4.
Arora S, Prakash TV, Carey RA, Hansdak SG, 2016. Poncet’s disease: Unusual presentation of a common disease. Lancet 387: 617–618.
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5.
Narendran G, Swaminathan S, 2016. TB-HIV co-infection: A catastrophic comradeship. Oral Dis 22 (Suppl 1): 46–52.
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6.
Pan L, Lu M-P, Wang J-H, Xu M, Yang S-R, 2020. Immunological pathogenesis and treatment of systemic lupus erythematosus. World J Pediatr 16: 19–30.
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7.
Korn T, Bettelli E, Oukka M, Kuchroo VK, 2009. IL-17 and Th17 cells. Annu Rev Immunol 27: 485–517.
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8.
Sulaiman T et al., 2020. The diagnostic utility of the “Thwaites’ system” and “lancet consensus scoring system” in tuberculous vs. non-tuberculous subacute and chronic meningitis: Multicenter analysis of 395 adult patients. BMC Infect Dis 20: 788.
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9.
Klein RS, Garber C, Howard N, 2017. Infectious immunity in the central nervous system and brain function. Nat Immunol 18: 132–141.
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10.
Vogrig A, Muñiz-Castrillo S, Desestret V, Joubert B, Honnorat J, 2020. Pathophysiology of paraneoplastic and autoimmune encephalitis: Genes, infections, and checkpoint inhibitors. Ther Adv Neurol Disord 13: 1756286420932797.
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11.
Barbosa-Silva MC, Lima MN, Battaglini D, Robba C, Pelosi P, Rocco PRM, Maron-Gutierrez T, 2021. Infectious disease-associated encephalopathies.Crit Care 25: 236.
| Past two years | Past Year | Past 30 Days | |
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Opsoclonus Myoclonus Ataxia Syndrome: An Atypical Presentation of Tuberculous Meningitis
Diksha Gupta
Diksha Gupta
Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India
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Achanya Palayullakandi
Achanya Palayullakandi
Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India
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Suthiraj Sopanam
Suthiraj Sopanam
Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India
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Prateek Kumar Panda
drprateekpanda@gmail.com
Prateek Kumar Panda
Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India
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Indar Kumar Sharawat
Indar Kumar Sharawat
Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India
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ABSTRACT.
Opsoclonus myoclonus ataxia syndrome (OMAS) is a rare neuroinflammatory disorder that is typically associated with paraneoplastic and postinfectious processes. Opsoclonus myoclonus ataxia syndrome has not been previously reported in association with tuberculous meningitis (TBM). This report presents a unique case in which TBM manifested as OMAS, highlighting the complex interplay between tuberculosis and autoimmune neurological conditions. A 1.5-year-old previously healthy girl, presented with acute-onset jerky movements, opsoclonus, irritability, and reduced sleep over 4 weeks. A neurological examination revealed opsoclonus, irritability, generalized tremulousness, and fragmentary myoclonus. Neuroimaging was suggestive of TBM. A cerebrospinal fluid (CSF) analysis indicated lymphocytic pleocytosis with positive CSF cartridge-based nucleic acid amplification test results for tuberculosis. The patient was treated with methylprednisolone pulse therapy, intravenous immunoglobulins, and anti-tuberculous therapy (ATT). Significant symptom improvement was observed within 2 weeks. This case underscores a rare association between OMAS and TBM, demonstrating that tuberculosis can trigger OMAS through autoimmune mechanisms. A timely diagnosis and treatment with ATT and immunotherapy can lead to substantial recovery.
Author Notes
Disclosures: None of the authors has any conflicts of interest to disclose. We confirm that we have read the journal’s position on issues involved in ethical publication and affirm that this report is consistent with those guidelines.
Current contact information: Diksha Gupta, Palayullakandi Achanya, Sopanam Suthiraj, Prateek Kumar Panda, and Indar Kumar Sharawat, Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India, E-mails: diksha179401gupta@gmail.com, achu8101p@gmail.com, suthiraj.s@gmail.com, drprateekpanda@gmail.com, and sherawatdrindar@gmail.com.
ProCite
RefWorks
Reference Manager
BibTeX
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-
1.
Oh S-Y, Kim J-S, Dieterich M, 2019. Update on opsoclonus-myoclonus syndrome in adults. J Neurol 266: 1541–1548.
-
2.
Auconi M, Papetti L, Ruscitto C, Ferilli MAN, Ursitti F, Sforza G, Vigevano F, Valeriani M, 2021. Opsoclonus-myoclonus syndrome in children and adolescents: A therapeutic challenge. Children 8: 965.
-
3.
Gilchrist H, Patterson JW, 2010. Erythema nodosum and erythema induratum (nodular vasculitis): Diagnosis and management. Dermatol Ther 23: 320–327.
-
4.
Arora S, Prakash TV, Carey RA, Hansdak SG, 2016. Poncet’s disease: Unusual presentation of a common disease. Lancet 387: 617–618.
-
5.
Narendran G, Swaminathan S, 2016. TB-HIV co-infection: A catastrophic comradeship. Oral Dis 22 (Suppl 1): 46–52.
-
6.
Pan L, Lu M-P, Wang J-H, Xu M, Yang S-R, 2020. Immunological pathogenesis and treatment of systemic lupus erythematosus. World J Pediatr 16: 19–30.
-
7.
Korn T, Bettelli E, Oukka M, Kuchroo VK, 2009. IL-17 and Th17 cells. Annu Rev Immunol 27: 485–517.
-
8.
Sulaiman T et al., 2020. The diagnostic utility of the “Thwaites’ system” and “lancet consensus scoring system” in tuberculous vs. non-tuberculous subacute and chronic meningitis: Multicenter analysis of 395 adult patients. BMC Infect Dis 20: 788.
-
9.
Klein RS, Garber C, Howard N, 2017. Infectious immunity in the central nervous system and brain function. Nat Immunol 18: 132–141.
-
10.
Vogrig A, Muñiz-Castrillo S, Desestret V, Joubert B, Honnorat J, 2020. Pathophysiology of paraneoplastic and autoimmune encephalitis: Genes, infections, and checkpoint inhibitors. Ther Adv Neurol Disord 13: 1756286420932797.
-
11.
Barbosa-Silva MC, Lima MN, Battaglini D, Robba C, Pelosi P, Rocco PRM, Maron-Gutierrez T, 2021. Infectious disease-associated encephalopathies.Crit Care 25: 236.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 1789 | 1789 | 97 |
| Full Text Views | 34 | 34 | 13 |
| PDF Downloads | 44 | 44 | 15 |