The Cerebellum

, Volume 18, Issue 6, pp 1151–1153 | Cite as

Vestibular Hyperreflexia and Opsoclonus in Acute Hepatitis A Virus Infection

  • Sun-Uk Lee
  • Juyoung Lee
  • Hyo-Jung Kim
  • Jeong-Yoon ChoiEmail author
  • Hui Jong Oh
  • Ji-Soo Kim
Letter to the Editor

Dear sir,

Opsoclonus refers to a burst of involuntary, arrhythmic, to-and-fro saccadic oscillations in multiple planes without an intersaccadic pause [1, 2]. Opsoclonus usually results from autoimmunity from preceding infections or dormant neoplasm [3, 4]. Opsoclonus often presents with other neurological symptoms and signs such as dizziness, myoclonus, ataxia, and mental confusion [3, 4]. In this study, we report vestibular hyperreflexia in a patient with opsoclonus-myoclonus syndrome as a rare complication of acute hepatitis A virus (HAV) infection.

A previously healthy, 52-year-old woman presented with fever, myalgia, and general weakness for a week. The patient was febrile with a body temperature at 38.6 °C. The initial serologic tests revealed 1390 IU of aspartate transaminase (reference range [RR] = 0–40), 1090 IU of alanine transaminase (RR = 0–40), and 586 IU of r-glutamyl transpeptidase (RR = 8–35). Viral hepatitis was diagnosed with the anti-hepatitis A IgM antibody in the...


Financial Disclosures

This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science and ICT (NRF-2017R1C1B1008582).

Author Contributions

Dr. S.U. Lee analyzed and interpreted the data and wrote the manuscript. Drs. H.J. Kim, J. Lee, H.J. Oh, and J.S. Kim analyzed and interpreted the data and revised the manuscript. Dr. J.Y. Choi designed and conceptualized the study, interpreted the data, and revised the manuscript.

Compliance with Ethical Standards

Conflict of Interest

Dr. J.S. Kim serves as an associate editor of Frontiers in Neuro-otology and on the editorial boards of the Journal of Korean Society of Clinical Neurophysiology, the Journal of Clinical Neurology, Frontiers in Neuro-ophthalmology, the Journal of Neuro-ophthalmology, the Journal of Vestibular Research, the Journal of Neurology, and Medicine. Others have no conflicts of interest to disclose.

Ethical Standard

This study followed the tenets of the Declaration of Helsinki and was performed according to the guidelines of the Institutional Review Board of Seoul National University Bundang Hospital (B-1802-448-704).


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Sun-Uk Lee
    • 1
    • 2
  • Juyoung Lee
    • 3
  • Hyo-Jung Kim
    • 4
  • Jeong-Yoon Choi
    • 2
    • 3
    Email author
  • Hui Jong Oh
    • 5
  • Ji-Soo Kim
    • 2
    • 3
  1. 1.Department of NeurologyKorea University Medical CenterSeoulSouth Korea
  2. 2.Department of NeurologySeoul National University College of MedicineSeoulSouth Korea
  3. 3.Dizziness Center, Clinical Neuroscience Center, and Department of NeurologySeoul National University Bundang HospitalSeongnamSouth Korea
  4. 4.Research Administration TeamSeoul National University Bundang HospitalSeongnamSouth Korea
  5. 5.The MTV (Migraine, Tinnitus, and Vertigo) Clinic, Oh Neurology CenterDaeguSouth Korea

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