Opsoclonus Myoclonus Syndrome in a Case of Severe Acute Malnutrition in Children: A Case Report

Abstract

Opsoclonus myoclonus syndrome (OMS) is a rare (1 in 10 million people per year) but nonfatal autoimmune disorder characterized by involuntary oscillating eye movements, multifocal muscular jerky movements, severe ataxia, and neuropsychological and behavioral changes. It usually manifests as a paraneoplastic condition but has other etiologies also. To the best of our knowledge, this is the first case of OMS seen in a patient with severe acute malnutrition (SAM). Parents brought a three-year-old female child with complaints of being unable to sit, stand, and hold her neck for the past 18 months. The patient has had involuntary eyeball movements for three months and has shown regression in milestones. Our study aimed to understand the pathophysiology, etiology, and clinical course of OMS in a child with SAM. However, relapses and long-term developmental sequelae are common due to the lack of a common consensus regarding therapeutic guidelines.

Review of Opsoclonus-Myoclonus Ataxia Syndrome in Pediatric Patients

“…OMAS also has a para-infectious etiology; studies have reported its association with Epstein–Barr virus [ 12 ], hepatitis C virus [ 13 ], rotavirus [ 14 ], adenovirus [ 15 ], enterovirus [ 16 ], rhinovirus, RSV [ 17 ], human herpesvirus 6 [ 18 ], malaria [ 19 ], and COVID-19 [ 20 ]. Some studies have shown the development of OMAS to be secondary to immune reconstitution after highly active antiretroviral therapy (HAART) for HIV [ 21 ] and severe acute malnutrition [ 22 ], while its association with type 1 diabetes mellitus [ 23 , 24 ] and Aicardi–Goutières syndrome [ 25 ] has also been reported.…”

An Insightful Observation Leading to a Late Diagnosis of Spinal Muscular Atrophy: A Case Report

“…The disease has a prevalence of around 1 per 100,000 persons. It primarily affects the motor neurons of the anterior horn cells of the central nervous system [ 1 ]. These motor neurons are responsible for skeletal muscle activity in the body [ 2 ].…”

“…The remaining 5% includes other mutations in different locations. This gene is located in the telomeric regions of chromosome 5q13 and is important for maintaining the integrity of motor neurons [ 1 ]. An identical gene known as SMN2 is hypothesized to be involved in the disease as well.…”