Opsoclonus Myoclonus Ataxia Syndrome: An Atypical Presentation of Tuberculous Meningitis.

Publication date: Jan 07, 2025

Opsoclonus myoclonus ataxia syndrome (OMAS) is a rare neuroinflammatory disorder that is typically associated with paraneoplastic and postinfectious processes. Opsoclonus myoclonus ataxia syndrome has not been previously reported in association with tuberculous meningitis (TBM). This report presents a unique case in which TBM manifested as OMAS, highlighting the complex interplay between tuberculosis and autoimmune neurological conditions. A 1. 5-year-old previously healthy girl, presented with acute-onset jerky movements, opsoclonus, irritability, and reduced sleep over 4 weeks. A neurological examination revealed opsoclonus, irritability, generalized tremulousness, and fragmentary myoclonus. Neuroimaging was suggestive of TBM. A cerebrospinal fluid (CSF) analysis indicated lymphocytic pleocytosis with positive CSF cartridge-based nucleic acid amplification test results for tuberculosis. The patient was treated with methylprednisolone pulse therapy, intravenous immunoglobulins, and anti-tuberculous therapy (ATT). Significant symptom improvement was observed within 2 weeks. This case underscores a rare association between OMAS and TBM, demonstrating that tuberculosis can trigger OMAS through autoimmune mechanisms. A timely diagnosis and treatment with ATT and immunotherapy can lead to substantial recovery.

Concepts Keywords
Ataxia Ataxia
Girl Autoimmune
Lymphocytic Csf
Methylprednisolone Irritability
Weeks Meningitis
Myoclonus
Neurological
Omas
Opsoclonus
Rare
Syndrome
Tbm
Tuberculosis
Tuberculous
Weeks

Semantics

Type Source Name
disease MESH Opsoclonus Myoclonus Ataxia
disease MESH Syndrome
disease MESH Tuberculous Meningitis
disease MESH neuroinflammatory disorder
disease MESH tuberculosis
pathway KEGG Tuberculosis
disease MESH opsoclonus
disease MESH myoclonus
disease MESH pleocytosis
disease IDO nucleic acid
drug DRUGBANK Methylprednisolone
drug DRUGBANK 5-amino-1 3 4-thiadiazole-2-thiol
disease IDO symptom

Original Article

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