Ocular flutter and truncal ataxia may be associated with enterovirus infection

Wiest, Gerald; Safoschnik, Georg; Schnaberth, G; Mueller, Christian

doi:10.1007/s004150050088

Cited by 27 publications

(21 citation statements)

References 12 publications

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“…Our patients did not exhibit deafness, which has been described in familiar syndromes associating myoclonus (cortical reflex myoclonus or action myoclonus) and ataxia [3,4]. The syndrome associating ocular flutter and truncal ataxia due to enterovirus infection is different from our description [5]. Our patients did not present eclampsia, and a cerebral angiopathy [6] is unlikely.…”

contrasting

confidence: 47%

Acute Ataxia with Axial Myoclonus during Pregnancy

Manto

Gille²

2002

Eur Neurol

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contrasting

confidence: 47%

Acute Ataxia with Axial Myoclonus during Pregnancy

Manto

Gille²

2002

Eur Neurol

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“…A mildly increased lymphocytic cell count usually in tens or hundreds is often reported in OMS [1,4,7,13,18,20,21,26,29,30,35,39,40,42,43,45]. We also observed mononuclear pleocytosis, which tended to become more elevated in the more advanced phase of the disease.…”

Section: Discussionmentioning

confidence: 54%

“…Repeated vomiting or at least nausea at the onset is another common clinical feature [1,3,4,9,13,15,16,20,26,35,43,45,47] which also occurred in our patients. These signs are due to brainstem involvement supported by both histopathological [10,21,39,46,47] and brain MRI findings [2,17].…”

Section: Discussionmentioning

confidence: 73%

“…Prevailing truncal ataxia over limb dysmetria [1,4,5,13,27,35,40,43,45] may be considered as a striking cerebellar feature in the majority of OMS patients. Therefore the term dysequilibrium was added to characterize our patients.…”

Section: Discussionmentioning

confidence: 99%

“…Identification of the specific microorganism is, however, very rare [3,7,12,13,20,30,35,40,45]. OMS is assumed to be immune mediated [13,23,31,47].…”

Section: Introductionmentioning

confidence: 99%

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Opsoclonus—myoclonus—dysequilibrium syndrome: cytological and immunological dynamics in the serial cerebrospinal fluid in two patients

Bartoš

Piťha

2003

J Neurol

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A peculiar clinical presentation characterized by the triad of opsoclonus,myoclonus and ataxia, mainly in a form of dysequilibrium, is usually associated with infectious or paraneoplastic processes. Serial cerebrospinal fluid (CSF) analysis in two patients with opsoclonus-myoclonus-dysequilibrium syndrome suggestive of viral encephalitis were performed from disease onset for up to 8 months. A cell count, cytology, total protein and glucose concentrations in CSF, the blood-CSF barrier function, intrathecal synthesis of immunoglobulins (Ig) in class M, G and A expressed as IgM, IgG and IgA indices and oligoclonal IgG bands were monitored. Cellular and humoral alterations in both patients were slight at the onset becoming more pronounced a month later. The kinetics of the CSF changes mirrored the subacute clinical deterioration and subsequent recovery. The delayed response in the CSF measures and the gradual clinical deterioration suggest the development of subacute brain inflammation. A mononuclear pleocytosis, including macrophages and plasma cells, increased within the first month and then normalized during the following weeks. Intrathecally synthesized IgM occurred only transiently after one month of illness, whereas intrathecal IgG production increased during the first month and persisted for at least eight months. An increasing number of oligoclonal IgG bands during the course, indicative of expanding local intrathecal synthesis, was noted. The dynamics of these CSF changes supports the hypothesis that opsoclonus-myoclonus syndrome is a post-infectious immune- mediated condition.

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Ocular Flutter, Generalized Myoclonus, and Trunk Ataxia Associated With Anti-GQ1b Antibodies

Zaro-Weber¹,

Galldiks²,

Dohmen³

et al. 2008

Arch Neurol

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Objective: To describe a movement disorder characterized by ocular flutter, trunk ataxia, and mild generalized myoclonus associated with anti-GQ1b antibodies.Design: Case report.Setting: University hospital. Patient:A 37-year-old woman presented with rapid, conjugated, and periodic oscillations of the eyes with a strict preponderance for the horizontal plane (ocular flutter); trunk ataxia; and occasional arrhythmic muscle jerks (myoclonus) most pronounced at the neck. Results: Brain magnetic resonance imaging results were normal. Cerebrospinal fluid examination revealed mild lymphocytic pleocytosis. Results of extensive serologi-cal tests on viral, bacterial, and fungal infections from blood and cerebrospinal fluid samples were unremarkable. Results of screening examinations for neoplasms and paraneoplastic antibodies, including whole-body fludeoxyglucose F18 positron emission tomography, were normal. Positive titers of IgG and IgM anti-GQ1b antibodies were found.Conclusions: This is the first description of an association between the clinical syndrome of ocular flutter, mild stimulus sensitive myoclonus, and trunk ataxia and anti-GQ1b antibodies. The association with ganglioside antibodies lends further support to the notion of an autoimmune-associated pathology of the syndrome.

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Ocular flutter and truncal ataxia may be associated with enterovirus infection

Cited by 27 publications

References 12 publications

Acute Ataxia with Axial Myoclonus during Pregnancy

Acute Ataxia with Axial Myoclonus during Pregnancy

Opsoclonus—myoclonus—dysequilibrium syndrome: cytological and immunological dynamics in the serial cerebrospinal fluid in two patients

Ocular Flutter, Generalized Myoclonus, and Trunk Ataxia Associated With Anti-GQ1b Antibodies

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