Wallace Alexander, Thomas Jonathan, Boren Jake, Bryant Chris, Brewer Jonathan, Dhanani Rahim
Texas A&M College of Medicine, Baylor University Medical Center, Dallas, TX, USA.
Emergency Medicine Residency, Baylor University Medical Center, Dallas, TX, USA.
Neurohospitalist. 2025 Jul 15:19418744251361303. doi: 10.1177/19418744251361303.
Opsoclonus-myoclonus-ataxia syndrome (OMAS) is a rare neurological condition most often diagnosed as a paraneoplastic or parainfectious syndrome. There have been some reports of OMAS in association with West Nile virus (WNV) in the literature, but both treatment and outcomes have been variable. Furthermore, some evidence suggests that patients who are treated earlier in the disease course have better outcomes, both in terms of time to disease remission and long-term symptom relief. Here, we present the case of a healthy 26-year-old patient who suddenly developed tremulousness and weakness of the lower extremities which progressively worsened over the course of 5 days; during this time, the patient developed nausea, gait unsteadiness, and rapid uncontrollable eye movements, leading to his hospital presentation. On hospital day two, the patient was diagnosed with OMAS due to exam findings of rapid, conjugate, saccadic bursts and myoclonic muscle activity, with serum and cerebrospinal fluid studies positive for WNV. Treatment with intravenous steroids and immunoglobulin began immediately afterwards and resulted in rapid improvement by the time of discharge 7 days after treatment was initiated. This case demonstrates the importance of developing broad differential diagnoses for uncommon disease presentations and the importance of treatment timeliness for better outcomes of OMAS. Furthermore, this report shows the need for more systematic studies on OMAS treatment and outcomes, as the current literature is somewhat limited due to the sporadic nature of the disease. Lastly, we highlight the patient's own heartfelt narrative of this illness and his experiences with recovery.
眼阵挛-肌阵挛-共济失调综合征（OMAS）是一种罕见的神经系统疾病，最常被诊断为副肿瘤性或副感染性综合征。文献中有一些关于OMAS与西尼罗河病毒（WNV）相关的报道，但治疗方法和结果各不相同。此外，一些证据表明，在疾病病程早期接受治疗的患者，无论是在疾病缓解时间还是长期症状缓解方面，都有更好的结果。在此，我们报告一例26岁健康患者的病例，该患者突然出现下肢震颤和无力，并在5天内逐渐加重；在此期间，患者出现恶心、步态不稳和快速无法控制的眼球运动，随后入院。在住院第二天，由于检查发现快速、共轭、扫视性眼动爆发和肌阵挛性肌肉活动，且血清和脑脊液检查WNV呈阳性，患者被诊断为OMAS。随后立即开始静脉注射类固醇和免疫球蛋白治疗，在开始治疗7天后出院时病情迅速改善。该病例表明，对于不常见的疾病表现进行广泛鉴别诊断的重要性，以及治疗及时性对OMAS获得更好结果的重要性。此外，本报告显示需要对OMAS的治疗和结果进行更系统的研究，因为由于该疾病的散发性，目前的文献有些有限。最后，我们强调了患者对这种疾病的亲身感受以及他的康复经历。
