Opsoclonus myoclonus syndrome in two cases with neuroborreliosis

Skeie, Geir; Eldøen, Guttorm; Skeie, Bente Sandvei; Midgard, Rune; Kristoffersen, E. K.; Bindoff, Laurence A.

doi:10.1111/j.1468-1331.2007.01959.x

Cited by 19 publications

(6 citation statements)

References 5 publications

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“…Reviewing three adult cases of OMAS as a manifestation of LD previously reported in English literature,34 , 36 some similarities were found in our case. All presented with acute onset, fast progression, and the emergency treatment was acyclovir.…”

Section: Discussionsupporting

confidence: 80%

“…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%

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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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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

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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“…Ante-mortem diagnosis of dementia with Lewy bodies (DLB) and differentiating it from Alzheimer’s disease (AD) are important to determine prognosis and better management [ 1 , 2 ]. Some patients with DLB have an accelerated disease progression and respond well to cholinesterase inhibitors, and approximately half of the patients experience life threatening adverse reactions to antipsychotic medications [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Accuracy of 123I-Meta-Iodobenzylguanidine Myocardial Scintigraphy in Dementia with Lewy Bodies: A Multicenter Study

et al. 2015

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Background and PurposeDementia with Lewy bodies (DLB) needs to be distinguished from Alzheimer’s disease (AD) because of important differences in patient management and outcome. Severe cardiac sympathetic degeneration occurs in DLB, but not in AD, offering a potential system for a biological diagnostic marker. The primary aim of this study was to investigate the diagnostic accuracy, in the ante-mortem differentiation of probable DLB from probable AD, of cardiac imaging with the ligand 123I-meta-iodobenzylguanidine (MIBG) which binds to the noradrenaline reuptake site, in the first multicenter study.MethodsWe performed a multicenter study in which we used 123I-MIBG scans to assess 133 patients with clinical diagnoses of probable (n = 61) or possible (n = 26) DLB or probable AD (n = 46) established by a consensus panel. Three readers, unaware of the clinical diagnosis, classified the images as either normal or abnormal by visual inspection. The heart-to-mediastinum ratios of 123I-MIBG uptake were also calculated using an automated region-of-interest based system.ResultsUsing the heart-to-mediastinum ratio calculated with the automated system, the sensitivity was 68.9% and the specificity was 89.1% to differentiate probable DLB from probable AD in both early and delayed images. By visual assessment, the sensitivity and specificity were 68.9% and 87.0%, respectively. In a subpopulation of patients with mild dementia (MMSE ≥ 22, n = 47), the sensitivity and specificity were 77.4% and 93.8%, respectively, with the delayed heart-to-mediastinum ratio.ConclusionsOur first multicenter study confirmed the high correlation between abnormal cardiac sympathetic activity evaluated with 123I-MIBG myocardial scintigraphy and a clinical diagnosis of probable DLB. The diagnostic accuracy is sufficiently high for this technique to be clinically useful in distinguishing DLB from AD, especially in patients with mild dementia.

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“…In cases of paraneoplastic OMS, small cell lung cancer, breast cancer, and ovarian cancer were most commonly encountered in adults (10), whereas more than half of these cases were associated with neuroblastoma in children (11,12). In OMS with a confirmed infectious agent, psittacosis (10,13), Mycoplasma infection (14), Salmonella infection (10,15,16), group A streptococcal infection (17), neuroborreliosis (18,19), Rickettsia infection (10), St. Louis encephalitis (10,20), coxsackievirus (10), enterovirus 71 (21), cytomegalovirus (22), Epstein-Barr virus (23), human immunodeficiency virus (24), and hepatitis C virus (25) have been described as the causative agents. Although the case of a 30-year-old woman with OMS 15 days after anti-rubella vaccination has been reported (26), seasonal influenza vaccination-related OMS has not yet been reported.…”

Section: Discussionmentioning

confidence: 99%

Opsoclonus-Myoclonus Syndrome Following Influenza A Infection

et al. 2012

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A 60-year-old woman developed opsoclonus-myoclonus syndrome (OMS) a week after being diagnosed with influenza A infection by a rapid antigen test. She had no loss of consciousness. Opsoclonus, myoclonus, and truncal ataxia were noted. Two weeks after treatment with intravenous immunoglobulin and corticosteroids, her opsoclonus, myoclonus, and truncal ataxia disappeared. No malignant tumors were detected during the 3-year follow-up period. There has been no previous report of postinfectious OMS following confirmed influenza A infection. OMS without a loss of consciousness has been reported to be statistically less common in cases of non-paraneoplastic OMS. This finding was consistent with the present patient's clinical manifestations.

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Opsoclonus myoclonus syndrome in two cases with neuroborreliosis

Cited by 19 publications

References 5 publications

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

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

Diagnostic Accuracy of 123I-Meta-Iodobenzylguanidine Myocardial Scintigraphy in Dementia with Lewy Bodies: A Multicenter Study

Opsoclonus-Myoclonus Syndrome Following Influenza A Infection

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