Opsoclonus-myoclonus syndrome caused by varicella-zoster virus

Singh, Dilip Kumar; Sinha, Mumun; Kumar, Rajesh; Shukla, Rakesh; Rc, Ahuja

doi:10.4103/0972-2327.70876

Cited by 15 publications

(10 citation statements)

References 3 publications

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“…Up to 50% of children with OMA harbor neuroblastoma; rest are associated with flu vaccine, infection with Streptococcus EBV, Mycoplasma pneumoniae , St. Louis virus, varicella rarely malaria, hepatitis C, and human immunodeficiency virus. [4567] Treatment for OMS from whatever the cause has not been uniformly successful. In children, this syndrome usually resolves with ACTH, or corticosteroid, but in most of the patients, symptoms recur after withdrawal.…”

Section: Discussionmentioning

confidence: 99%

Opsoclonus myoclonus ataxia syndrome due to falciparum malaria in two Indian children

Bose

Saha

Islam

et al. 2016

Indian J Ophthalmol

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Section: Discussionmentioning

confidence: 99%

Opsoclonus myoclonus ataxia syndrome due to falciparum malaria in two Indian children

Bose

Saha

Islam

et al. 2016

Indian J Ophthalmol

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“…In about half of patients it is seen as a paraneoplastic syndrome most commonly associated with neuroblastic tumors, with neuroblastoma in more than half the pediatric cases 1 , 10 , 16 - 18. Infectious, post-infectious, post-vaccinal, and idiopathic cases were also reported.…”

Section: Discussionmentioning

confidence: 99%

“…Rarer oncologic associations include melanoma,21 - 23 and other neoplasms of the gynecologic tract,10 , 24 - 27 as well as cancers of the urologic,15 , 28 , 29 hematologic,30 - 32 and gastrointestinal systems 15. Infections (mainly virus), idiopathic cases, and rarely toxic or metabolic disturbances account for the other half.…”

Section: Discussionmentioning

confidence: 99%

“…Parainfectious causes may be diverse and include agents such as cytomegalovirus, EBV, Coxsackie virus, West Nile virus, HIV, varicella-zoster virus, Influenza A virus, hepatitis C virus, Mycoplama pneumoniae , Salmonella sp., Ricketsia, group A streptococci, mumps, Lyme Disease (LD), and psittacosis 2 , 10 , 14 , 17 , 34 , 36 , 49 - 59. OMAS was also described after measles, mumps, and rubella vaccine 60.…”

Section: Discussionmentioning

confidence: 99%

“…In about half of patients it is seen as a paraneoplastic syndrome most commonly associated with neuroblastic tumors, with neuroblastoma in more than half the pediatric cases. 1 , 10 , 16 - 18 Infectious, post-infectious, post-vaccinal, and idiopathic cases were also reported. The clinical presentation, detection of autoantibodies, response to immunosuppressive treatment, and the long-term outcome are similar concerning the idiopathic and neuroblastoma-associated cases.…”

Section: Discussionmentioning

confidence: 99%

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Adult-onset opsoclonus-myoclonus-ataxia syndrome as a manifestation of brazilian lyme disease-like syndrome: a case report and review of literature

Lino¹,

Spera²,

Campos³

et al. 2014

ACR

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Described in 1962, the opsoclonus-myoclonus-ataxia syndrome (OMAS) is a rare, neurologically debilitating disorder with distinct characteristics that may begin in childhood or adult life. Although many cases remain without etiological diagnosis, others are related to neoplasms and infectious diseases. We report a 41-year-old previously healthy male with an 8-day history of headache, vertigo, nausea, vomiting, and nystagmus. After a normal brain computed tomography and lymphocytic pleocytosis in cerebral spinal fluid (CSF), intravenous acyclovir therapy was initiated in the emergency room. On the third day of hospitalization, the diagnosis of OMAS was made based on the presence of chaotic and irregular eye movements, dysarthric speech, gait instability, generalized tremor, and myoclonic jerks. In the face of his neurological worsening, ampicillin followed by nonspecific immunotherapy (methylprednisolone and intravenous immunoglobulin) was prescribed, with mild clinical improvement. After a thorough laboratory workup, the definite diagnosis of neuroborreliosis was established and ceftriaxone (4 g/daily/3 wks) and doxycycline (200 mg/day/2 mo) was administered. Toward the end of the ceftriaxone regimen, the neurologic signs substantially improved. We believe this to be the first case description of OMAS as clinical presentation of Brazilian Lyme disease-like syndrome (Baggio-Yoshinari syndrome).

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Multifactorial analysis of opsoclonus‐myoclonus syndrome etiology (“Tumor” vs. “No tumor”) in a cohort of 356 US children

Pranzatelli

Tate

McGee

2018

Pediatric Blood & Cancer

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Background: Pediatric opsoclonus-myoclonus syndrome (OMS) presents a paradox of etiopathogenesis: A neuroblastic tumor (NB) is found in only one half of the cases, the others are ascribed to infections or designated as idiopathic. Method:From an IRB-approved observational study of 356 US children with OMS, secondary analysis of "etiology" and related factors was performed on a well-characterized cohort. The "Tumor" (n = 173) and "No Tumor" groups (n = 183), as defined radiologically, were compared according to multiple factors considered potentially differentiating. Data were analyzed retrospectively using parametric and nonparametric tests as indicated.Results: Patients with NB were not distinguishable by prodromal symptoms, OMS onset age, gender, race/ethnicity, OMS severity, rank order of neurological sign appearance, or geographic distribution. Various CSF immunologic biomarker abnormalities of OMS did not vary in the presence or absence of a detectable tumor: frequency of six lymphocyte subsets, or concentrations of 18 cytokines/chemokines, cytokine antagonists, chemokine receptors, cell adhesion molecules, or neuronal/glial markers. Prior responsiveness to conventional immunotherapy was not contingent on tumor/no tumor designation. Conclusions:Multiple convergent factors provide compelling empirical evidence and rationalize the concept that OMS is one neurological disorder, regardless of apparent etiology. Limitations to the current clinical etiologic classifications as paraneoplastic, parainfectious/post-infectious, and idiopathic etiology require antigen-based biological solutions to tease out the molecular pathophysiology of viral/tumoral mechanisms. Systematic studies, regardless of presumed etiology, will be necessary to find the highest-yield combination of imaging approaches, screening for infectious agents, and new biomarkers. Two testable hypotheses for future research are presented.

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Opsoclonus-myoclonus syndrome caused by varicella-zoster virus

Cited by 15 publications

References 3 publications

Opsoclonus myoclonus ataxia syndrome due to falciparum malaria in two Indian children

Opsoclonus myoclonus ataxia syndrome due to falciparum malaria in two Indian children

Adult-onset opsoclonus-myoclonus-ataxia syndrome as a manifestation of brazilian lyme disease-like syndrome: a case report and review of literature

Multifactorial analysis of opsoclonus‐myoclonus syndrome etiology (“Tumor” vs. “No tumor”) in a cohort of 356 US children

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