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Opsoclonus-myoclonus syndrome with severe clinical course and beneficial outcome: A case report

RATIONALE: Opsoclonus-myoclonus syndrome (OMS) is a rare immune-mediated movement disorder, mostly of paraneoplastic or idiopathic origin. The disease usually has an acute onset, serious course and leads rapidly to disability in adult patients. To the best of our knowledge, this is the fourth presen...

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Autores principales: Koziorowska-Gawron, Ewa, Koszewicz, Magdalena, Bladowska, Joanna, Ejma, Maria, Budrewicz, Slawomir
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8036019/
https://www.ncbi.nlm.nih.gov/pubmed/33832088
http://dx.doi.org/10.1097/MD.0000000000025261
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author Koziorowska-Gawron, Ewa
Koszewicz, Magdalena
Bladowska, Joanna
Ejma, Maria
Budrewicz, Slawomir
author_facet Koziorowska-Gawron, Ewa
Koszewicz, Magdalena
Bladowska, Joanna
Ejma, Maria
Budrewicz, Slawomir
author_sort Koziorowska-Gawron, Ewa
collection PubMed
description RATIONALE: Opsoclonus-myoclonus syndrome (OMS) is a rare immune-mediated movement disorder, mostly of paraneoplastic or idiopathic origin. The disease usually has an acute onset, serious course and leads rapidly to disability in adult patients. To the best of our knowledge, this is the fourth presented case of OMS with a severe course and complete reversibility of neurological symptoms in a pregnant woman. This report includes videos and a literature review. PATIENT CONCERNS: A 30-year-old woman in the 12th week of pregnancy developed severe nausea and vomiting, after several days balance and gait disorders appeared. On admission to hospital, neurological examination revealed opsoclonus, dysarthria, myoclonic jerks with ataxia of the trunk and limbs with inability to sit, stand or walk. DIAGNOSIS: Well-known causes of OMS were excluded. Although in our patient the idiopathic origin of the disorder was taken under consideration, diagnosis of opsoclonus-myoclonus related to the pregnancy was highly likely. INTERVENTIONS: After administration of steroids and benzodiazepines the patient improved. OUTCOMES: In the 6th month of pregnancy, after termination of immunotherapy, she recovered completely and was able to sit, stand and walk independently. In the 39th week of pregnancy, she delivered a healthy child. LESSONS: We confirm that understanding of clinical symptoms and rare causes of OMS contributes to early diagnosis and therapy, which ensures an optimal outcome. One probable cause of OMS could be a physiological change to immune system regulation during pregnancy. The relationship between OMS and pregnancy remains uncertain and needs further investigation.
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spelling pubmed-80360192021-04-13 Opsoclonus-myoclonus syndrome with severe clinical course and beneficial outcome: A case report Koziorowska-Gawron, Ewa Koszewicz, Magdalena Bladowska, Joanna Ejma, Maria Budrewicz, Slawomir Medicine (Baltimore) 5300 RATIONALE: Opsoclonus-myoclonus syndrome (OMS) is a rare immune-mediated movement disorder, mostly of paraneoplastic or idiopathic origin. The disease usually has an acute onset, serious course and leads rapidly to disability in adult patients. To the best of our knowledge, this is the fourth presented case of OMS with a severe course and complete reversibility of neurological symptoms in a pregnant woman. This report includes videos and a literature review. PATIENT CONCERNS: A 30-year-old woman in the 12th week of pregnancy developed severe nausea and vomiting, after several days balance and gait disorders appeared. On admission to hospital, neurological examination revealed opsoclonus, dysarthria, myoclonic jerks with ataxia of the trunk and limbs with inability to sit, stand or walk. DIAGNOSIS: Well-known causes of OMS were excluded. Although in our patient the idiopathic origin of the disorder was taken under consideration, diagnosis of opsoclonus-myoclonus related to the pregnancy was highly likely. INTERVENTIONS: After administration of steroids and benzodiazepines the patient improved. OUTCOMES: In the 6th month of pregnancy, after termination of immunotherapy, she recovered completely and was able to sit, stand and walk independently. In the 39th week of pregnancy, she delivered a healthy child. LESSONS: We confirm that understanding of clinical symptoms and rare causes of OMS contributes to early diagnosis and therapy, which ensures an optimal outcome. One probable cause of OMS could be a physiological change to immune system regulation during pregnancy. The relationship between OMS and pregnancy remains uncertain and needs further investigation. Lippincott Williams & Wilkins 2021-04-09 /pmc/articles/PMC8036019/ /pubmed/33832088 http://dx.doi.org/10.1097/MD.0000000000025261 Text en Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0 (https://creativecommons.org/licenses/by/4.0/)
spellingShingle 5300
Koziorowska-Gawron, Ewa
Koszewicz, Magdalena
Bladowska, Joanna
Ejma, Maria
Budrewicz, Slawomir
Opsoclonus-myoclonus syndrome with severe clinical course and beneficial outcome: A case report
title Opsoclonus-myoclonus syndrome with severe clinical course and beneficial outcome: A case report
title_full Opsoclonus-myoclonus syndrome with severe clinical course and beneficial outcome: A case report
title_fullStr Opsoclonus-myoclonus syndrome with severe clinical course and beneficial outcome: A case report
title_full_unstemmed Opsoclonus-myoclonus syndrome with severe clinical course and beneficial outcome: A case report
title_short Opsoclonus-myoclonus syndrome with severe clinical course and beneficial outcome: A case report
title_sort opsoclonus-myoclonus syndrome with severe clinical course and beneficial outcome: a case report
topic 5300
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8036019/
https://www.ncbi.nlm.nih.gov/pubmed/33832088
http://dx.doi.org/10.1097/MD.0000000000025261
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