Adult-onset opsoclonus-myoclonus-ataxia syndrome as a manifestation of brazilian lyme disease-like syndrome: a case report and review of literature
Described in 1962, the opsoclonus-myoclonus-ataxia syndrome (OMAS) is a rare, neurologically debilitating disorder with distinct characteristics that may begin in childhood or adult life. Although many cases remain without etiological diagnosis, others are related to neoplasms and infectious disease...
Main Authors: | , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
University of São Paulo
2014-03-01
|
Series: | Autopsy and Case Reports |
Subjects: | |
Online Access: | http://www.revistas.usp.br/autopsy/article/view/81208 |
id |
doaj-1ddc9365f59449748c7c6632e27c819d |
---|---|
record_format |
Article |
spelling |
doaj-1ddc9365f59449748c7c6632e27c819d2020-11-24T23:01:14ZengUniversity of São PauloAutopsy and Case Reports2236-19602014-03-014110.4322/acr.%y.8120877831Adult-onset opsoclonus-myoclonus-ataxia syndrome as a manifestation of brazilian lyme disease-like syndrome: a case report and review of literatureAngelina Maria Martins Lino0Raphael Ribeiro Spera1Fernando Peixoto Ferraz de Campos2Christian Henrique de Andrade Freitas3Márcio Ricardo Taveira Garcia4Leonardo da Costa Lopes5Aleksander Snioka Prokopowitsch6Divisão de Clínica Médica do Hospital Universitário da USPDepartamento de Neurologia do Hospital das Clínicas da Fac. de Medicina da USPDivisão de Clínica Médica do Hospital Universitário da USPDepartamento de Neurologia do Hospital das Clínicas da Fac. de Medicina da USPDepartamento de Radiologia do Instituto do Câncer do Estado de São PauloDivisão de Clínica Médica do Hospital Universitário da USPDivisão de Clínica Médica do Hospital Universitário da USPDescribed in 1962, the opsoclonus-myoclonus-ataxia syndrome (OMAS) is a rare, neurologically debilitating disorder with distinct characteristics that may begin in childhood or adult life. Although many cases remain without etiological diagnosis, others are related to neoplasms and infectious diseases. We report a 41-year-old previously healthy male with an 8-day history of headache, vertigo, nausea, vomiting, and nystagmus. After a normal brain computed tomography and lymphocytic pleocytosis in cerebral spinal fluid (CSF), intravenous acyclovir therapy was initiated in the emergency room. On the third day of hospitalization, the diagnosis of OMAS was made based on the presence of chaotic and irregular eye movements, dysarthric speech, gait instability, generalized tremor, and myoclonic jerks. In the face of his neurological worsening, ampicillin followed by nonspecific immunotherapy (methylprednisolone and intravenous immunoglobulin) was prescribed, with mild clinical improvement. After a thorough laboratory workup, the definite diagnosis of neuroborreliosis was established and ceftriaxone (4 g/daily/3wks) and doxycycline (200 mg/day/2 mo) was administered. Toward the end of the ceftriaxone regimen, the neurologic signs substantially improved. We believe this to be the first case description of OMAS as clinical presentation of Brazilian Lyme disease-like syndrome (Baggio-Yoshinari syndrome).http://www.revistas.usp.br/autopsy/article/view/81208Opsoclonus-Myoclonus SyndromeLyme NeuroborreliosisBorrelia burgdorferi. |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Angelina Maria Martins Lino Raphael Ribeiro Spera Fernando Peixoto Ferraz de Campos Christian Henrique de Andrade Freitas Márcio Ricardo Taveira Garcia Leonardo da Costa Lopes Aleksander Snioka Prokopowitsch |
spellingShingle |
Angelina Maria Martins Lino Raphael Ribeiro Spera Fernando Peixoto Ferraz de Campos Christian Henrique de Andrade Freitas Márcio Ricardo Taveira Garcia Leonardo da Costa Lopes Aleksander Snioka Prokopowitsch Adult-onset opsoclonus-myoclonus-ataxia syndrome as a manifestation of brazilian lyme disease-like syndrome: a case report and review of literature Autopsy and Case Reports Opsoclonus-Myoclonus Syndrome Lyme Neuroborreliosis Borrelia burgdorferi. |
author_facet |
Angelina Maria Martins Lino Raphael Ribeiro Spera Fernando Peixoto Ferraz de Campos Christian Henrique de Andrade Freitas Márcio Ricardo Taveira Garcia Leonardo da Costa Lopes Aleksander Snioka Prokopowitsch |
author_sort |
Angelina Maria Martins Lino |
title |
Adult-onset opsoclonus-myoclonus-ataxia syndrome as a manifestation of brazilian lyme disease-like syndrome: a case report and review of literature |
title_short |
Adult-onset opsoclonus-myoclonus-ataxia syndrome as a manifestation of brazilian lyme disease-like syndrome: a case report and review of literature |
title_full |
Adult-onset opsoclonus-myoclonus-ataxia syndrome as a manifestation of brazilian lyme disease-like syndrome: a case report and review of literature |
title_fullStr |
Adult-onset opsoclonus-myoclonus-ataxia syndrome as a manifestation of brazilian lyme disease-like syndrome: a case report and review of literature |
title_full_unstemmed |
Adult-onset opsoclonus-myoclonus-ataxia syndrome as a manifestation of brazilian lyme disease-like syndrome: a case report and review of literature |
title_sort |
adult-onset opsoclonus-myoclonus-ataxia syndrome as a manifestation of brazilian lyme disease-like syndrome: a case report and review of literature |
publisher |
University of São Paulo |
series |
Autopsy and Case Reports |
issn |
2236-1960 |
publishDate |
2014-03-01 |
description |
Described in 1962, the opsoclonus-myoclonus-ataxia syndrome (OMAS) is a rare, neurologically debilitating disorder with distinct characteristics that may begin in childhood or adult life. Although many cases remain without etiological diagnosis, others are related to neoplasms and infectious diseases. We report a 41-year-old previously healthy male with an 8-day history of headache, vertigo, nausea, vomiting, and nystagmus. After a normal brain computed tomography and lymphocytic pleocytosis in cerebral spinal fluid (CSF), intravenous acyclovir therapy was initiated in the emergency room. On the third day of hospitalization, the diagnosis of OMAS was made based on the presence of chaotic and irregular eye movements, dysarthric speech, gait instability, generalized tremor, and myoclonic jerks. In the face of his neurological worsening, ampicillin followed by nonspecific immunotherapy (methylprednisolone and intravenous immunoglobulin) was prescribed, with mild clinical improvement. After a thorough laboratory workup, the definite diagnosis of neuroborreliosis was established and ceftriaxone (4 g/daily/3wks) and doxycycline (200 mg/day/2 mo) was administered. Toward the end of the ceftriaxone regimen, the neurologic signs substantially improved. We believe this to be the first case description of OMAS as clinical presentation of Brazilian Lyme disease-like syndrome (Baggio-Yoshinari syndrome). |
topic |
Opsoclonus-Myoclonus Syndrome Lyme Neuroborreliosis Borrelia burgdorferi. |
url |
http://www.revistas.usp.br/autopsy/article/view/81208 |
work_keys_str_mv |
AT angelinamariamartinslino adultonsetopsoclonusmyoclonusataxiasyndromeasamanifestationofbrazilianlymediseaselikesyndromeacasereportandreviewofliterature AT raphaelribeirospera adultonsetopsoclonusmyoclonusataxiasyndromeasamanifestationofbrazilianlymediseaselikesyndromeacasereportandreviewofliterature AT fernandopeixotoferrazdecampos adultonsetopsoclonusmyoclonusataxiasyndromeasamanifestationofbrazilianlymediseaselikesyndromeacasereportandreviewofliterature AT christianhenriquedeandradefreitas adultonsetopsoclonusmyoclonusataxiasyndromeasamanifestationofbrazilianlymediseaselikesyndromeacasereportandreviewofliterature AT marcioricardotaveiragarcia adultonsetopsoclonusmyoclonusataxiasyndromeasamanifestationofbrazilianlymediseaselikesyndromeacasereportandreviewofliterature AT leonardodacostalopes adultonsetopsoclonusmyoclonusataxiasyndromeasamanifestationofbrazilianlymediseaselikesyndromeacasereportandreviewofliterature AT aleksandersniokaprokopowitsch adultonsetopsoclonusmyoclonusataxiasyndromeasamanifestationofbrazilianlymediseaselikesyndromeacasereportandreviewofliterature |
_version_ |
1725640250627194880 |