Opsoclonus myoclonus ataxia associated with West Nile virus infection: A dramatic presentation with benign prognosis?

J Neurol Sci. 2017 May 15;376:38-41. doi: 10.1016/j.jns.2017.02.057. Epub 2017 Feb 27.

Abstract

Opsoclonus myoclonus and ataxia is a combination of severe neurological signs associated with several pathologic agents and conditions. Only few cases of opsoclonus have been related to West Nile virus infection. We report on a 61-year-old woman and on a 55-year-old man who had history of recent fever, who were hospitalized because of acute severe truncal ataxia, opsoclonus and tremor with minimal myoclonic jerks. A through work-up revealed the presence of both IgM and IgG antibodies against West Nile virus both in the serum and Cerebrospinal Fluid and excluded other causes known to be associated with this combination of neurological signs. The first case was treated with corticosteroids, followed by significant improvement, and the second recovered spontaneously. The acute combination of opsoclonus, severe truncal ataxia and tremor with a history of recent fever requires, during the relevant season and in the relevant geographic area, a search for a recent infection with West Nile virus. Though initially suffering from a devastating sickness, our patients eventually recovered.

Keywords: Ataxia; Eye movements; Opsoclonus; Saccades; West Nile virus.

Publication types

  • Case Reports
  • Video-Audio Media

MeSH terms

  • Brain / diagnostic imaging
  • Female
  • Humans
  • Male
  • Middle Aged
  • Opsoclonus-Myoclonus Syndrome / complications*
  • Opsoclonus-Myoclonus Syndrome / diagnosis*
  • Opsoclonus-Myoclonus Syndrome / drug therapy
  • Prognosis
  • West Nile Fever / complications*
  • West Nile Fever / diagnosis*
  • West Nile Fever / drug therapy