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Opsoclonus Myoclonus Ataxia Syndrome: An Atypical Presentation of Tuberculous Meningitis
Diksha Gupta
Diksha Gupta
Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India
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Achanya Palayullakandi
Achanya Palayullakandi
Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India
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Suthiraj Sopanam
Suthiraj Sopanam
Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India
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Prateek Kumar Panda
drprateekpanda@gmail.com
Prateek Kumar Panda
Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India
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Indar Kumar Sharawat
Indar Kumar Sharawat
Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India
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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.
Author Notes
Disclosures: None of the authors has any conflicts of interest to disclose. We confirm that we have read the journal’s position on issues involved in ethical publication and affirm that this report is consistent with those guidelines.
Current contact information: Diksha Gupta, Palayullakandi Achanya, Sopanam Suthiraj, Prateek Kumar Panda, and Indar Kumar Sharawat, Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India, E-mails: diksha179401gupta@gmail.com, achu8101p@gmail.com, suthiraj.s@gmail.com, drprateekpanda@gmail.com, and sherawatdrindar@gmail.com.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 478 | 478 | 478 |
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| PDF Downloads | 12 | 12 | 12 |