Skip to main content

Advertisement

SpringerLink
Log in

Opsoclonus-Myoclonus-Ataxia Syndrome Due to Covid-19

  • Case Report
  • Published:
The Cerebellum Aims and scope Submit manuscript

Abstract

Opsoclonus-myoclonus syndrome (OMS) as a rare neurological encephalopathic entity associated with non-specific infections or cancer processes has been repeatedly described in the setting of SARS-CoV-2 infection. We report a case of a 53-year-old man with SARS-CoV-2 infection, who developed clinical features of opsoclonus-myoclonus ataxia syndrome including cognitive impairments with a prolonged course of disease. Of particular note, cerebrospinal fluid (CSF) analysis revealed the production of myelin oligodendrocyte glycoprotein (MOG) antibodies, suggesting an underlying neuroimmunological mechanism associated with infection with the novel SARS-CoV-2 virus.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Data Availability

No datasets or materials can be accessed.

References

  1. Ritchie H, Mathieu E, Rodés-Guirao L, et al. Coronavirus pandemic (COVID-19). Our World in Data. https://ourworldindata.org/coronavirus.

  2. Balcom EF, Nath A, Power C. Acute and chronic neurological disorders in COVID-19: potential mechanisms of disease. Brain. 2021;144:3576–88.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Ellul MA, Benjamin L, Singh B, Lant S, et al. Neurological associations of COVID-19. Lancet Neurol. 2020;19(9):767–83.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Helms J, Kremer S, Merdji H, et al. Neurological features in severe SARS-CoV-2 infection. N Engl J Med. 2020;382(23):2268–70.

    Article  PubMed  Google Scholar 

  5. Jha NK, Ohja S, Jha SK, Dureja H, et al. Evidence of coronavirus (CoV) pathogenesis and emerging pathogen SARS-CoV-2 in the nervous system: a review on neurological impairments and manifestations. J Mol Neurosci. 2021;71:2192–209.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Sriwastava S, Tandon M, Podury S, Prasad A, et al. COVID-19 and neuroinflammation: a literature review of relevant neuroimaging and CFS markers in central nervous system inflammatory disorders from Sars-CoV2. J Neurol. 2021;268(12):4448–78.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Chacko J, Maramattom BV. Parainfectious opsoclonus myoclonus syndrome with COVID-19. Ann Indian Acad Neurol. 2022;25(3):546–8.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Emamikkah M, Babadi M, Mehrabani M, Jalili M, et al. Opsoclonus-myoclonus syndrome, a post-infectious neurologic complication of COVID-19: case series and review of the literature. J Neuro-Oncol. 2021;27(1):26–34.

    Google Scholar 

  9. Foucard C, San-Galli A, Tarrano C, Chaumont H, et al. Acute cerebellar ataxia and myoclonus with or without opsoclonus: a para-infectious syndrome associated with COVID-19. Eur J Neurol. 2021;28(10):3533–6.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Heald DL, Devine IM, Smith RL, Holsopple SAT, Arasmith JL, Arnold RW. Opsoclonus after COVID-19 in an infant. Pediatr Neurol. 2021;117:34.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Ishaq H, Durrani T, Umar Z, Khan N, McCombe P, Ul Haq MA. Post-COVID opsoclonus myoclonus syndrome: a case report from Pakistan. Front Neurol. 2021;12:672524.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Ismail II, Kamel WA, Kilany A. Opsoclonus myoclonus ataxia syndrome following COVID-19 infection. Acta Neurol Belg. 2023;123(2):715–6.

    Article  PubMed  Google Scholar 

  13. Kini TA, Guduru Z. Opsoclonus-myoclonus in COVID-19 infection. A known clinical presentation in new disease. J Neuroophthalmol. 2022;42(2):e526.

    Article  PubMed  Google Scholar 

  14. Nelson JL, Blume GM, Bansal SK, Kaufman JR, Woods FR, Zhang X, Kattah JC. Postinfectious SARS-CoV-2 opsoclonus-myoclonus-ataxia syndrome. J Neuroophthalmol. 2022;42(2):251–5.

    Article  PubMed  Google Scholar 

  15. Saha B, Saha S, Chong WH. 78-year-old woman with opsoclonus myoclonus ataxia syndrome secondary to COVID-19. BMJ Case Rep. 2021;14:e243165.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Sanguinetti SY, Ramdhani RA. Opsoclonus-myoclonus-ataxia syndrome related to the novel coronavirus (COVID-19). J Neuroophthalmol. 2021;41(3):e288–9.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Shah PB, Desai SD. Opsoclonus myoclonus ataxia syndrome in the setting of COVID-19 infection. Neurology. 2021;96(1):33.

    Article  CAS  PubMed  Google Scholar 

  18. Vijayaraghavan R, Paramanandam V, Sankaranarayanan M, Kankanala M, Bindu PH, Safinaaz ANM. The double whammy-opsoclonus-myoclonus-ataxia syndrome and COVID-19: a case report. Ann Indian Acad Neurol. 2022;25(4):731–3.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Mirmosayyeb O, Ghaffary EM, Dehghan MS, Ghoshouni H, et al. Myelin oligodenrocyte glycoprotein antibody-associated disease and Covid-19: a systematic review. J Cent Nerv Syst Dis. 2023;15:1–15.

    Article  Google Scholar 

  20. Goh EL, Scarff K, Satariano S, Lim M, Anand G. Evolving cognitive dysfunction in children with neurologically stable opsoclonus-myclonus syndrome. Children. 2020;7(9):104.

    Article  Google Scholar 

  21. Gorman MP. Update on diagnosis, treatment, and prognosis in opsoclonus-myoclonus-ataxia syndrome. Curr Opin Pediatr. 2010;22:745–50.

    Article  PubMed  Google Scholar 

  22. Chan JL, Murphy KA, Sarna JR. Myoclonus and cerebellar ataxia associated with COVID-19: a case report and systematic review. J Neurol. 2021;268(10):3517–48.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Ertekin V, Tan H. Opsoclonus–myoclonus syndrome attributable to Hepatitis C infection. Pediatr Neurol. 2010;42:441–2.

    Article  PubMed  Google Scholar 

  24. Glatz K, Meinck HM, Wildemann B. Parainfectious opsoclonus myoclnus syndrome: high dose intravenous immunoglobulins are effective. J Neurol Neurosurg Psychiatry. 2003;74:279–80.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Kanjanasut N, Phanthumchinda K, Bhidayasiri R. HIV-related opsoclonus–myoclonus-ataxia syndrome: report on two cases. Clin Neurol Neurosurg. 2010;112:572–4.

    Article  PubMed  Google Scholar 

  26. Khosla JS, Edelman MJ, Kennedy N, Reich SG. West Nile virus presenting as opsoclonus–myoclonus cerebellar ataxia. Neurology. 2005;64:1095–5.

    Article  PubMed  Google Scholar 

  27. Oh SY, Kim JA, Dieterich M. Update on opsoclonus-myoclonus syndrome in adults. J Neurol. 2019;266(6):1541–8.

    Article  PubMed  Google Scholar 

  28. Verma A, Brozman B. Opsoclonus–myoclonus syn-drome following Epstein-Barr virus infection. Neurology. 2002;58:1131–2.

    Article  PubMed  Google Scholar 

  29. Zaganas I, Prinianakis G, Xirouchaki N, Mavridis M. Opsoclonus–myoclonus syndrome associated with cytomegalo-virus encephalitis. Neurology. 2007;68(1636):56.

    Google Scholar 

  30. Armangué T, Sabater L, Torres-Vega E, Martínez-Hernández E, et al. Clinical and Immunological Features of opsoclonus-myoclonus syndrome in the era of neuronal cell surface antibodies. JAMA Neurol. 2016;73(4):417–24.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Klaas JP, Ahlskog JE, Pittock SJ, Matsumoto JY, et al. Adult-onset opsoclonus-myoclonus syndrome. Arch Neurol. 2012;69(12):1598–607.

    Article  PubMed  Google Scholar 

  32. Bataller L, Rosenfeld MR, Graus F, Vilchez JJ, Cheung NKV, Dalmau J. Autoantigen diversity in the opsoclonus–myoclonus syndrome. Ann Neurol. 2003;53:347–53.

    Article  CAS  PubMed  Google Scholar 

  33. Trigo LJ, Martinez PE, Carrancho GA, Pedraza HMI. Opsoclonus-myoclonus syndrome secondary to duloxetine poisoning (Sindrome de opsoclono-mioclono secundario a intoxicación por dulocetina). Neurologia (Engl Ed). 2021;36(3):250–2.

    Article  Google Scholar 

  34. Durovic E, Bien C, Bien CG, Isenmann S. MOG antibodyassociated encephalitis secondary to Covid-19: a case report. BMC Neurol. 2021;21:414.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Peters J, Alhasan S, Vogels CBF, Grubaugh ND, et al. MOG-associated encephalitis following SARS-CoV-2 infection. Mult Scler Relat Disord. 2021;50:102857.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Adhikari S, Thuringer A, Maali L, Jassam Y. Opsoclonus myoclonus syndrome in a postpartum period. Mult Scler Relat Disord. 2021;50:102862.

    Article  CAS  PubMed  Google Scholar 

  37. Sato R, Okanari K, Maeda T, Kaneko K, et al. Postinfectious acute disseminated encephalomyelitis associated with antmyelin oligodendrocyte glycoprotein antibody. Child Neurol Open. 2020;7:1–5.

    Article  CAS  Google Scholar 

  38. Finsterer J, Scorza FA. Opsoclonus myoclonus ataxia syndrome due to SARS-CoV-2. Neuroophthalmology. 2022;47(1):1–6.

    Article  PubMed  Google Scholar 

  39. Blaes F, Fuehlhuber V, Korfei M, et al. Surface-binding autoantibodies to cerebellar neurons in opsoclonus syndrome. Ann Neurol. 2005;58(2):313–7.

    Article  CAS  PubMed  Google Scholar 

  40. Banks SA, Morris PP, Chen JJ, Pittock SJ, et al. Brainstem and cerebellar involvement in MOG-IgG-associated disorder cersus aquaporin-4-IgG and MS. J Neurol Neurosurg Psychiatry. 2020; https://doi.org/10.1136/jnnp-2020-325121.

  41. Sawalha K, Adeodokun S, Kamoga GR. Covid-19-induced acute bilateral optic neuritis. J Investig Med High Impact Case Rep. 2020;8:2324709620976018.

    PubMed  PubMed Central  Google Scholar 

  42. Levy A, Chen R. Myoclonus: pathophysiology and treatment options. Curr Treat Options Neurol. 2016;18(5):21.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors would like to thank the patient for his participation and permission to publish his medical data about his neurological disorder..

Funding

The present article was organized and submitted without any funding.

Author information

Authors and Affiliations

  1. Department of Neurological and Neurocognitive Rehabilitation, Klinik Bavaria Kreischa, An der Wolfsschlucht, 1-2 01731, Kreischa, Germany

    Michael Adamaszek

  2. Department of Radiology, Rostock University Medical Center, Schillingallee 35, 18057, Rostock, Germany

    Soenke Langner

  3. Department of Public Health, Dresden Medical School, Technical University Dresden, Dresden, Germany

    Jan Mehrholz

  4. Neurology and Psychiatry Group Practice, Geislingen, Germany

    Alexander Heiinrich

Authors
  1. Michael Adamaszek
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Soenke Langner
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jan Mehrholz
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Alexander Heiinrich
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Data recording and production of manuscript: Michael Adamaszek. All authors read and inserted own recommendations, and approved the final manuscript.

Corresponding author

Correspondence to Michael Adamaszek.

Ethics declarations

Ethical Approval

The authors confirm that the approval of an institutional review board was not required for this work. A written informed consent of the patient was obtained for the publication of his data. The authors have read the journal’s position on issues involved in ethical publication and affords that this work is consistent with those guidelines.

Competing Interests

The authors declare no competing interests.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Adamaszek, M., Langner, S., Mehrholz, J. et al. Opsoclonus-Myoclonus-Ataxia Syndrome Due to Covid-19. Cerebellum (2023). https://doi.org/10.1007/s12311-023-01610-9

Download citation

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s12311-023-01610-9

Keywords

Search

Navigation