[Adult-onset opsoclonus-myoclonus-ataxia syndrome revealing rubella meningoencephalitis]

Abstract

Introduction: Opsoclonus-myoclonus-ataxia (OMS) is a rare clinical syndrome, of paraneoplastic infectious, post-infectious, post-vaccinal or idiopathic origin.

Case report: We report a 24-year-old young man who presented with gait disorder preceded by a febrile rash and retroauricular lymph nodes. Three days before admission, he had headache, vertigo, nausea and vomiting followed by gait unsteadiness and movement disorders of limbs and eyes. On examination, he had OMS syndrome. Brain MRI, total body scan, MIBG scintigraphy, tumor markers and onconeural antibodies were normal. Cerebro-spinal fluid (CSF) analysis showed lymphocytic meningitis. Positive serum and CSF immunoglobulin M antibody against rubella virus was demonstrated. He received acyclovir with full recovery within two weeks. We discuss the peculiarities of this association with a literature review.

Conclusion: This observation enlarges the spectrum of neurological manifestations of rubella as well as that of OMS etiologies.

Keywords: Adult; Adulte; Kinsbourne; Meningoencephalitis; Méningo-encéphalite; Opsoclonus-myoclonus; Rubella; Rubéole.