Opsoclonus-myoclonus syndrome associated with persistent diarrheal disease: Case report in a male infant
Main Article Content
Abstract
Background: Opsoclonus-myoclonus syndrome (OMS) is an unusual neurological and inflammatory disorder characterized by opsoclonus, myoclonus, ataxia, and behavioral changes or sleep disturbances of paraneoplastic, infectious, or idiopathic etiology. We present the case of a male infant with opsoclonus-myoclonus syndrome secondary to persistent diarrheal disease. Case report: A five-month-old patient was admitted due to involuntary jerk-type movements and apparent disconnection from the environment, with a history of persistent diarrheal disease; complementary tests were performed with no evidence of abnormality. During the stay, the sensory alteration was documented with alternation between drowsiness and irritability, skin erythema, pruritus, recurrent episodes characterized by involuntary trunk movements and extremities of the brief jerking type associated with crying and irritability with ruddiness, with subsequent episodes of head and chest hesitation. Therefore, a diagnosis of opsoclonus-myoclonus syndrome is made, triggered by a probable enteral etiology. Conclusions: The patient's unusual presentation allows a review of the literature to sensitize the health professional in the early detection and treatment of this clinical entity.
Downloads
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Creative Commons
License Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0)
You are free to:
Share - copy and redistribute the material in any medium or format.
Adapt - remix, transform, and build upon the material The licensor cannot revoke these freedoms as long as you follow the license terms.
• Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
• NonCommercial — You may not use the material for commercial purposes.
• ShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.
• No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
References
Desai S, Gandhi F, Vaishnav A. Opsoclonus myoclonus syndrome: A rare manifestation of dengue infection in a child. J Pediatr Neurosci. 2018;13(4):455-458. DOI: https://doi.org/10.4103/JPN.JPN_55_18
Matthay KK, Blaes F, Hero B, Plantaz D, De Alarcon P, Mitchell WG, et al. Opsoclonus myoclonus syndrome in neuroblastoma a report from a workshop on the dancing eyes syndrome at the advances in neuroblastoma meeting in Genoa, Italy, 2004. In: Cancer Letters. 2005; 228(1-2):275-82. DOI: https://doi.org/10.1016/j.canlet.2005.01.051
Jiménez Legido M, Cantarín Extremera V, Fournier del Castillo M de la C, Melero Llorente J, González Gutiérrez-Solana L. Síndrome opsoclonus mioclonus. Experiencia en los últimos 12 años en un hospital terciario. An Pediatría. 2020;93(5):339-342. DOI: https://doi.org/10.1016/j.anpedi.2019.12.007
Muthusamy K, Thomas M, Yoganathan S, Sudhakar S. Clinical profile, prognostic indicators, and therapeutic outcomes of pediatric opsoclonus-myoclonus-ataxia syndrome: A single-center experience from South India. Ann Indian Acad Neurol. 2019; 22(3):295-301. DOI: https://doi.org/10.4103/aian.AIAN_101_18
Dalmau AJ, Rosenfeld MR. Opsoclonus-myoclonus syndrome. 2020;1–15.
Marsden CD, Hallett M, Fahn S. The nosology and pathophysiology of myoclonus. En: Movement Disorders. Butterworths International Medical Reviews. 1981. p. 196-248. DOI: https://doi.org/10.1016/B978-0-407-02295-9.50018-7
Hasegawa S, Matsushige T, Kajimoto M, Inoue H, Momonaka H, Oka M, et al. A nationwide survey of opsoclonus-myoclonus syndrome in Japanese children. Brain Dev. 2015; 37(7):656-60. DOI: https://doi.org/10.1016/j.braindev.2014.10.010
Huber BM, Strozzi S, Steinlin M, Aebi C, Fluri S. Mycoplasma pneumoniae associated opsoclonus–myoclonus syndrome in three cases. Eur J Pediatr. 2010; 169(4):441-5. DOI: https://doi.org/10.1007/s00431-009-1048-3
Garg R, Rizvi I, Malhotra H, Kumar N. Opsoclonus myoclonus syndrome in children: Paraneoplastic versus parainfectious. Neurology India. 2018; 66(5):1295-1298. DOI: https://doi.org/10.4103/0028-3886.241387
Pranzatelli MR, Tate ED, McGee NR. Demographic, clinical, and immunologic features of 389 children with opsoclonus-myoclonus syndrome: A cross-sectional study. Front Neurol. 2017;11;8:468. DOI: https://doi.org/10.3389/fneur.2017.00468
Radu RA, Terecoasă EO, Ene A, Băjenaru OA, Tiu C. Opsoclonus-myoclonus syndrome associated with West-nile virus infection: Case report and review of the literature. Frontiers in Neurology. 2018; 16;9:864. DOI: https://doi.org/10.3389/fneur.2018.00864
Gurkas E, Gucuyener K, Yilmaz U, Havali C, Demir E. Opsoclonus-myoclonus syndrome following rotavirus gastroenteritis. Pediatr Int. 2014; 56(6):e86-e87. DOI: https://doi.org/10.1111/ped.12433
Ki Pang K, Lynch BJ, Osborne JP, Pike MG. Dancing Eye Syndrome associated with spontaneous recovery and normal neurodevelopment. Eur J Paediatr Neurol. 2010; 14(2):178-81. DOI: https://doi.org/10.1016/j.ejpn.2009.04.011
Enfermedad diarreica aguda por rotavirus en pacientes ingresados en un servicio de gastroenterología pediátrica. Medisan. 2016; 20( 9 ): 2104-2110.
Karampatsas K, Osborne L, Seah ML, Tong CYW, Prendergast AJ. Clinical characteristics and complications of rotavirus gastroenteritis in children in east London: A retrospective case-control study. PLoS One. 2018; 13(3):e0194009. DOI: https://doi.org/10.1371/journal.pone.0194009
Canet JMS, Mejías AM. Complicaciones asociadas a la infección por rotavirus. 2015. Enfoque editorial S.C. Madrid.
Hero B, Schleiermacher G. Update on pediatric opsoclonus myoclonus syndrome. Neuropediatrics. 2013; 44(6):324-9. DOI: https://doi.org/10.1055/s-0033-1358604
Blaes F, Dharmalingam B. Childhood opsoclonus-myoclonus syndrome: diagnosis and treatment. Expert Rev Neurother. 2016;16(6):641-8. DOI: https://doi.org/10.1080/14737175.2016.1176914
Pranzatelli MR, Tate ED, McGee NR, Verhulst SJ. CSF neurofilament light chain is elevated in OMS (decreasing with immunotherapy) and other pediatric neuroinflammatory disorders. J Neuroimmunol. 2014; 266(1-2):75-81. DOI: https://doi.org/10.1016/j.jneuroim.2013.11.004
Pranzatelli MR, Tate ED, McGee NR, Ransohoff RM. CCR7 signaling in pediatric opsoclonus-myoclonus: Upregulated serum CCL21 expression is steroid-responsive. Cytokine. 2013;64(1):331-6. DOI: https://doi.org/10.1016/j.cyto.2013.05.020
Wilbur C, Yea C, Licht C, Irwin MS, Yeh EA. An upfront immunomodulatory therapy protocol for pediatric opsoclonus-myoclonus syndrome. Pediatr Blood Cancer. 2019;66(8):e27776. DOI: https://doi.org/10.1002/pbc.27776