Opsoclonus-myoclonus syndrome attributable to West Nile encephalitis: a case report

Bîrluțiu, Victoria; Bîrluţiu, Rareş Mircea

doi:10.1186/1752-1947-8-232

Cited by 13 publications

(11 citation statements)

References 15 publications

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“…There are several published reports on opsoclonus–myoclonus‐ataxia syndrome (OMAS) in patients with WNV infection . Of the 12 cases of OMAS reported so far, 9 were associated with other involuntary movements that include action tremor, truncal ataxia, and jaw tremor (Table ).…”

Section: Resultsmentioning

confidence: 99%

“…Interestingly, the majority (8 of 12) of the reported cases were women and were > 40 years of age. Of the 12 cases, 11 had a benign outcome with complete remission of the opsoclonus and myoclonus within months, whereas only 1 patient died 4 weeks after the onset of symptoms, and opsoclonus–myoclonus syndrome persisted till death . It is important to note that in the majority of the aforementioned reports (Table ), patients with OMAS were treated with intravenous immunoglobulins (IVIg) or intravenous steroids.…”

Section: Resultsmentioning

confidence: 99%

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Spectrum of Movement Disorders in Patients With Neuroinvasive West Nile Virus Infection

Lenka

Kamat

Mittal³

2019

Movement Disord Clin Pract

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Background West Nile virus (WNV) is a flavivirus that is recognized as one of the common causes of arboviral neurological disease in the world. WNV infections usually manifest with constitutional symptoms such as fever, fatigue, myalgia, rash, arthralgia, and headache. Neuroinvasive WNV infections are characterized by signs and symptoms suggestive of meningitis, encephalitis, meningoencephalitis, and acute flaccid paralysis. In addition, many patients with neuroinvasive WNV infection develop a wide range of movement disorders. This article aims to comprehensively review the spectrum and natural course of the movement disorders observed in patients with neuroinvasive WNV infections. Methods A literature search was performed in March 2019 (in PubMed and EMBASE) to identify articles for this review. Results Movement disorders observed in the context of WNV infections include tremor, opsoclonus–myoclonus, parkinsonism, myoclonus, ataxia, and chorea. Most often, these movement disorders resolve within a few weeks to months with an indolent course. The commonly observed tremor phenotypes include action tremor of the upper extremities (bilateral > unilateral). Tremor in patients with West Nile meningitis subsides earlier than that in patients with West Nile encephalitis/acute flaccid paralysis. Opsoclonus–myoclonus in WNV infections responds well to intravenous immunoglobulins/plasmapheresis/corticosteroids. Parkinsonism has been reported to be mild in nature and usually lasts for a few weeks to months in the majority of the patients. Conclusion A wide spectrum of movement disorders is observed in neuroinvasive WNV infections. Longitudinal studies are warranted to obtain better insights into the natural course of these movement disorders.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Spectrum of Movement Disorders in Patients With Neuroinvasive West Nile Virus Infection

Lenka

Kamat

Mittal³

2019

Movement Disord Clin Pract

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“…Encephalitides HSV (Park et al, 2011) EBV West Nile virus (Birlutiu and Birlutiu, 2014;Cooper and Said, 2014) SSPE (Sharma and Biswas, 2013;Shibasaki and Hallett, 2005) Mumps infections (Kang and Kim, 2014) Autoimmune (Balint et al, 2013;DeFelipe-Mimbrera et al, 2014;Ghoreishi et al, 2013;Leigh et al, 1980;Smith et al, 2011;Stern et al, 2014;Uehara et al, 2011) Paraneoplastic (Berger and Mehari, 1999;Kim et al, 2009;Kumar et al, 2005; Spinal cord Traumatic spinal cord injury Calancie (2006) individual has fallen, and it lasts for 1-16 s. The recognition of myoclonus associated with transient cerebral hypoxia is important in the context of critically ill patients, as during intensive care, patients can suddenly develop episodes of severe arterial hypotension that (if detected early) can be treated with vasopressors to avoid hypoxic brain injury. Distinguishing psychogenic from somatic myoclonus is challenging calling for the exclusion of somatic diseases.…”

Section: Metabolic Encephalopathiesmentioning

confidence: 99%

Myoclonus in the critically ill: Diagnosis, management, and clinical impact

Sutter

Ristic

Rüegg

et al. 2016

Clinical Neurophysiology

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Myoclonus is the second most common involuntary non-epileptic movement in intensive care units following tremor-like gestures. Although there are several types of myoclonus, they remain underappreciated, and their diagnostic and prognostic associations are largely ignored. This review discusses clinical, electrophysiological, neuroanatomical, and neuroimaging characteristics of different types of myoclonus in critically ill adults along with their prognostic impact and treatment options. Myoclonus is characterized by a sudden, brief, and sometimes repetitive muscle contraction of body parts, or a brief and sudden cessation of tonic muscle innervation followed by a rapid recovery of tonus. Myoclonus can resemble physiologic and other pathologic involuntary movements. Neurologic injuries, anesthetics, and muscle relaxants interfere with the typical appearance of myoclonus. Identifying "real myoclonus" and determining the neuroanatomical origin are important, as treatment responses depend on the involved neuroanatomical structures. The identification of the type of myoclonus, the involved neuroanatomical structures, and the associated illnesses is essential to direct treatment. In conclusion, the combined clinical, electrophysiological, and neuroradiological examination reliably uncovers the neuroanatomical sources and the pathophysiology of myoclonus. Recognizing cortical myoclonus is critical, as it is treatable and may progress to generalized convulsive seizures or status epilepticus.

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“…Even though OMS is not commonly caused by infections, there are case reports of viral encephalitis which had caused OMS such as varicella zoster, West Nile encephalitis [5], and mumps [6]. OMS after influenza vaccination was also reported [7] and in India OMS due to malaria had been reported [8].…”

Section: Discussionmentioning

confidence: 99%

Opsoclonus myoclonus syndrome in a patient with Japanese encephalitis: a case report

et al. 2017

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BackgroundOpsoclonus myoclonus syndrome is a rare neurological disorder that usually manifests as a paraneoplastic phenomenon. Although some viruses are reported to cause this condition, opsoclonus myoclonus syndrome by Japanese encephalitis has not been reported previously.Case presentationHere we present the case of a 31-year-old Sri Lankan woman who presented with fever, altered level of consciousness, opsoclonus, and facial myoclonus. She was diagnosed as having Japanese encephalitis based on cerebrospinal fluid and serum Japanese encephalitis-specific immunoglobulin M antibody and characteristic magnetic resonance imaging abnormalities. She was given intravenously administered methylprednisolone pulses (1000 mg per day) for 5 days. With this she improved gradually with reduction in opsoclonus and myoclonic movements. Her limb muscle power and speech also improved slowly.ConclusionsWe intended to highlight the fact that opsoclonus myoclonus syndrome can be a feature of infection with Japanese encephalitis and that it can be added to the list of viruses which cause opsoclonus. Currently there is no well-accepted treatment for opsoclonus myoclonus syndrome and intravenously administered methylprednisolone pulses and immunosuppressants can be used successfully in these patients for early recovery.

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Opsoclonus-myoclonus syndrome attributable to West Nile encephalitis: a case report

Cited by 13 publications

References 15 publications

Spectrum of Movement Disorders in Patients With Neuroinvasive West Nile Virus Infection

Spectrum of Movement Disorders in Patients With Neuroinvasive West Nile Virus Infection

Myoclonus in the critically ill: Diagnosis, management, and clinical impact

Opsoclonus myoclonus syndrome in a patient with Japanese encephalitis: a case report

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