Opsoclonus Myoclonus Ataxia Syndrome in the Setting of COVID-19 Infection

Abstract

A middle-aged man presented with imbalance and involuntary jerky movements of the body 3 weeks after initial recovery from coronavirus disease 2019 (COVID-19) lung infection, diagnosed by positive high-resolution CT thorax (COVID Reporting and Data System 5) and reverse transcription PCR (RT-PCR) from nasal swab.He had opsoclonus, cortical myoclonus, and symmetric cerebellar ataxia of speech, limbs, trunk, and gait on examination 1 (video 1).His MRI brain with contrast, CSF examination, HIV, Venereal Disease Research Laboratory, autoimmune, and paraneoplastic panel (including anti-GAD, antinuclear antibodies, antineutrophil cytoplasmic antibodies, anti-Hu, anti-Yo, anti-Ri, anti-amphiphysin, anti-PNAM2-Ma2/Ta antibodies), metabolic functions (hemogram, hematocrit, glucose, thyroid, renal, hepatic functions, electrolytes, serum and urine osmolality), and repeat nasal COVID-19 RT-PCR were normal.He recovered after treatment consisting of IV methylprednisolone (1 g/d), sodium valproate (20 mg/kg/d), clonazepam (2 mg/d), and levetiracetam (2 g/d) in 1 week (video 2).Our case adds to the increasing list of novel neurologic manifestations occurring in the setting of 3