Adult-onset opsoclonus-myoclonus syndrome due to West Nile Virus treated with intravenous immunoglobulin
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A 63-year-old female with no significant past medical history was presented with a 5-day history of progressive opsoclonus-myoclonus, headaches, and fevers. Her workup was significant only for positive West-Nile Virus serum serologies. She received a 2-day course of intravenous immunoglobulin (IvIG). At an 8-week follow up, she had a complete neurological remission. Adult-onset opsoclonus-myoclonus syndrome is a rare condition for which paraneoplastic and infectious causes have been attributed. To our knowledge, this is the first case reported of opsoclonus-myoclonus secondary to West-Nile Virus treated with intravenous immunoglobulin monotherapy.
KeywordsOpsoclonus-myoclonus syndrome West Nile virus
The authors would like to thank the patient for her collaboration with the publication of this case report.
Compliance with ethical standards
Financial Disclosure/Conflict of Interest concerning the research related to the manuscript
The authors declare that they have no conflict of interest.
Julien Hébert: Writing of the first draft
David Armstrong: Production of videos
Nick Daneman: Review and critique of manuscript
Jennifer Jain: Review and critique of manuscript
James Perry: Review and critique of manuscript
The first part of the video shows the clinical findings of this patient at presentation. Significant opsoclonus is first demonstrated in all directions of gaze. Myoclonus of the hands and mouth can be observed. In the second part of the video, we can appreciate that the patient has achieved a full neurological recovery. Standing up from a chair, tandem gait, and extra-ocular movements are normal. (MPG 44386 kb)
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