Clinical Neurology and Neurosurgery
Volume 112, Issue 7 , Pages 572-574, September 2010

HIV-related opsoclonus–myoclonus–ataxia syndrome: Report on two cases

  • Natlada Kanjanasut

      Affiliations

    • Chulalongkorn Comprehensive Movement Disorders Center, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand
  • ,
  • Kammant Phanthumchinda

      Affiliations

    • Chulalongkorn Comprehensive Movement Disorders Center, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand
  • ,
  • Roongroj Bhidayasiri

      Affiliations

    • Chulalongkorn Comprehensive Movement Disorders Center, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand
    • Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA
    • Corresponding Author InformationCorresponding author at: Chulalongkorn Comprehensive Movement Disorders Center, Chulalongkorn University Hospital, 1873 Rama 4 Road, Bangkok 10330, Thailand. Tel.: +66 2 256 4627; fax: +66 2 256 4630.

Received 7 August 2009; received in revised form 11 March 2010; accepted 29 March 2010.

Abstract 

Opsoclonus–myoclonus–ataxia (OMA) syndrome is a rare neurological disorder, characterized by a rapid onset of generalized myoclonus in association with chaotic multi-directional eye movements and, less frequently, cerebellar ataxia. OMA is commonly related to a paraneoplastic process, specifically neuroblastoma in children and lung or breast cancer in adults. Nevertheless, OMA may occur in association with various infectious agents, such as Coxsackie virus B3, Epstein-Barr virus, mumps, enterovirus, and streptococcus. We recently encountered two cases of HIV-related OMA syndrome. The first patient developed a sudden onset of OMA at the time of HIV seroconversion. The second patient experienced severe ataxia with a mild degree of myoclonus and opsoclonus, associated with an elevated CD4 count following the initiation of highly active antiretroviral therapy (HAART). We suggest that OMA syndrome may be another rare manifestation of HIV infection at the time of seroconversion or during an immune restoration period.

Keywords: Opsoclonus–myoclonus–ataxia syndrome, Human immunodeficiency virus, Immune-mediated mechanism, Seroconversion, Immune reconstitution inflammatory syndrome

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PII: S0303-8467(10)00097-1

doi:10.1016/j.clineuro.2010.03.024

Clinical Neurology and Neurosurgery
Volume 112, Issue 7 , Pages 572-574, September 2010