Opsoclonus-Myoclonus-Ataxia Syndrome with Parainfective Etiology: A Case Report and Evaluation of Treatment Response Using the Mitchell Pike OMS-Rating Scale

Abstract

Abstract Opsoclonus-myoclonus-ataxia syndrome (OMS), also known as Kinsbourne syndrome or dancing eyes-dancing feet syndrome, is a variable constellation of neurological symptoms. The majority of reported adult cases have been paraneoplastic, often associated with antineuronal nuclear antibody type 2 (ANNA-2; anti-Ri). However, its association with parainfective triggers remains underexplored in scientific literature. We present a unique and rare case of OMS diagnosed as secondary to acute viral cerebellitis. The patient exhibited opsoclonus, myoclonus, and ataxia, with cerebrospinal fluid analysis revealing lymphocytic pleocytosis and mildly elevated protein levels, indicative of a viral etiology. Investigations ruled out paraneoplastic OMS. The patient was managed with acyclovir, plasmapheresis, and steroids, resulting in a significant improvement in the Mitchell Pike scale score. The combined treatment approach led to progressive neurological improvement. This case report emphasizes the potential role of antiviral therapy, plasmapheresis, and steroids in managing parainfective OMS. It highlights the importance of considering viral etiologies in OMS cases and underscores the benefits of this therapeutic strategy. Furthermore, this case report also highlights the utility of the Mitchell Pike OMS-Rating Scale for the evaluation of treatment response. Clinicians should be diligent in investigating parainfective triggers and individualizing treatment approaches to optimize outcomes in OMS patients.