Res Vestib Sci.
2017 Mar;16(1):34-37. 10.21790/rvs.2017.16.1.34.
Opsoclonus-Myoclonus Syndrome Associated with Scrub Typhus
- Affiliations
-
- 1Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Busan, Korea. kdchoi@pusan.ac.kr
- 2Department of Neurology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea.
- KMID: 2371825
- DOI: http://doi.org/10.21790/rvs.2017.16.1.34
Abstract
- Scrub typhus is an infective acute febrile disorder caused by the intracellular parasite Orientia tsutsugamushi. Neurological manifestations of scrub typhus are meningoencephalitis, cerebellitis, transverse myelitis, papilledema, and cranial nerve palsy. However, opsoclonus-myoclonus syndrome associated with scrub typhus has been rarely reported. A 59-year-old man developed vertigo, nausea, vomiting, and imbalance following scrub typhus infection for eight days. Examination showed eschar at the axilla, decreased mentality, and opsoclonus-myoclonus syndrome. Video-oculography disclosed opsoclonus with an amplitude of 15°-20° and a frequency of 6-8 Hz. The serum antibody titers to Orientia tsutsugamushi were 1:5,120, and cerebrospinal fluid analysis revealed pleocytosis. Brain magnetic resonance imaging was normal. Neurological symptoms and signs completely improved by systemic steroid and antibiotics treatment. Various mechanisms including direct disseminating inflammation or indirect immune modulation may give rise to neurological complications following scrub typhus.
MeSH Terms
-
Anti-Bacterial Agents
Axilla
Brain
Cerebrospinal Fluid
Cranial Nerve Diseases
Encephalitis
Humans
Inflammation
Leukocytosis
Magnetic Resonance Imaging
Meningoencephalitis
Middle Aged
Myelitis, Transverse
Nausea
Neurologic Manifestations
Ocular Motility Disorders
Opsoclonus-Myoclonus Syndrome*
Orientia tsutsugamushi
Papilledema
Parasites
Scrub Typhus*
Vertigo
Vomiting
Anti-Bacterial Agents
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