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April 06, 2015; 84 (14 Supplement) APRIL 21, 2015

Opsoclonus Myoclonus Ataxia Syndrome Due To

Mycobacterium tuberculosis Rhombencephalitis In A
Patient With HIV. (P2.318)
Juan Parada and Immer Armendariz Betancour

First published April 8, 2015,

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Abstract
Background: Opsoclonus myoclonus ataxia syndrome is a rare and distinct neurological
disorder characterised by opsoclonus, myoclonus and ataxia, along with behavioural changes
in adults. The etiology in adults is due to a self-limiting presumed para-infectious brainstem
encephalitis but it may also represent a paraneoplastic syndrome in nearly 60[percnt] of cases,
most commonly small cell lung cancer and breast carcinoma. Mycobacterium tuberculosis
although an uncommon cause of OMAS, is very common cause for RE in
immunocompromised patients. Design and methods: A 46 year old Latin male with PMH of
X.linked hipertricosis was in usual state of health 7 days prior to admission. Few days before
admission he woke up with ataxia, myoclonus and fever. His symptoms persisted and 3 days
before admission developed opsoclonus, somnolence and hyporexia. At admission whe noted
the presence of fever of 38.5C, tachycardia of 115bpm, opsoclonus, action multifocal
myoclonus, ataxia and left intention tremmor with hypermetria. He was empirically treated
with ampicillin and acyclovir. Results: Hb 5.9, neutropenia 1.54 and lymphopenia 0.64. CSF :
WBC of 30 with 100[percnt] mononuclear and protein 303 and Glucose 32. MRI Brain
showed: DWI/ T2/FLAIR hyperintensity demonstrated within the left midbrain tegmentum,
left pons tegmentum, left middle cerebral peduncle and left cerebellar hemisphere. These
findings are compatible with RE. Blood and CSF culture were negative, CSF PCR for
Mycobacterium tuberculosis was positive and positive
WB for HIV. Antituberculous therapy was started. Conclusion: Tuberculosis is a rare cause of
infectious RE and OMAS and HIV is a known cause of OMAS and a important risk factor for
developing tuberculosis. Tuberculosis could be added to the list of aetiologies to be screened
in OMS, as it would allow effective treatment.

Disclosure: Dr. Parada has nothing to disclose. Dr. Armendariz has received personal
compensation for activities with Hospital Metropolitano.
Tuesday, April 21 2015, 7:30 am-12:00 pm

Copyright © 2015 by AAN Enterprises, Inc.

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