Radu Răzvan Alexandru, Terecoasă Elena Oana, Ene Amalia, Băjenaru Ovidiu Alexandru, Tiu Cristina
Department of Neurology, University Emergency Hospital Bucharest, Bucharest, Romania.
Department of Clinical Neurosciences, University of Medicine and Pharmacy Carol Davila, Bucharest, Romania.
Front Neurol. 2018 Oct 16;9:864. doi: 10.3389/fneur.2018.00864. eCollection 2018.
Opsoclonus-myoclonus syndrome (OMS) is a very rare condition with different autoimmune, infectious and paraneoplastic aetiologies or in most cases idiopathic. We report the case of a 75-year-old woman who was admitted in our department in early fall for altered mental status, opsoclonus, multifocal myoclonus, truncal titubation and generalized tremor, preceded by a 5 day prodrome consisting of malaise, nausea, fever and vomiting. Brain computed tomography and MRI scans showed no significant abnormalities and cerebrospinal fluid changes consisted of mildly increased protein content and number of white cells. Work-up for paraneoplastic and autoimmune causes of OMS was negative but serologic tests identified positive IgM and IgG antibodies against West Nile virus (WNV). The patient was treated with Dexamethasone and Clonazepam with progressive improvement of mental status, myoclonus, opsoclonus and associated neurologic signs. Six months after the acute illness she had complete recovery. To our knowledge this is the 14th case of WNV associated OMS reported in the literature so far. We briefly describe the clinical course of the other reported cases together with the different treatment strategies that have been employed.
眼阵挛-肌阵挛综合征（OMS）是一种非常罕见的疾病，病因包括不同的自身免疫性、感染性和副肿瘤性因素，或在大多数情况下病因不明。我们报告了一例75岁女性病例，该患者于初秋因精神状态改变、眼阵挛、多灶性肌阵挛、躯干共济失调和全身性震颤入院，在此之前有5天的前驱症状，包括不适、恶心、发热和呕吐。脑部计算机断层扫描和磁共振成像扫描未显示明显异常，脑脊液变化包括蛋白含量和白细胞数量轻度增加。对OMS的副肿瘤性和自身免疫性病因的检查结果为阴性，但血清学检测发现抗西尼罗河病毒（WNV）的IgM和IgG抗体呈阳性。患者接受了地塞米松和氯硝西泮治疗，精神状态、肌阵挛、眼阵挛及相关神经体征逐渐改善。急性病发作6个月后她完全康复。据我们所知，这是迄今为止文献报道的第14例WNV相关的OMS病例。我们简要描述了其他已报道病例的临床病程以及所采用的不同治疗策略。
