HIV-related opsoclonus-myoclonus-ataxia syndrome: report on two cases.
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.
Kanjanasut
Natlada
N
Chulalongkorn Comprehensive Movement Disorders Center, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
Phanthumchinda
Kammant
K
Bhidayasiri
Roongroj
R
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D001259:Ataxia / Q000209:etiology* / Q000473:pathology; D001921:Brain / Q000473:pathology; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000473:pathology; D015658:HIV Infections / Q000150:complications*; D006679:HIV Seropositivity; D006801:Humans; D054019:Immune Reconstitution Inflammatory Syndrome / Q000150:complications / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D053578:Opsoclonus-Myoclonus Syndrome / Q000209:etiology* / Q000473:pathology