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Opsoclonus persisting during sleep in West Nile encephalitis
Amer Alshekhlee1, Badr Sultan, Krishan Chandar
1Department of Neurology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio, USA. amer.alshekhlee@uhhs.com
Archives of Neurology
|September 13, 2006
Summary
West Nile virus can cause opsoclonus-myoclonus syndrome, a rare neurological condition. Eye movement artifacts on electroencephalography during sleep may indicate this syndrome.
Area of Science:
- Neurology
- Infectious Diseases
- Ophthalmology
Background:
- West Nile virus (WNV) outbreaks are associated with neurological complications, including paralysis.
- Ocular motor system involvement is an uncommon manifestation of WNV infection.
Observation:
- A 53-year-old male presented with symptoms of viral prodrome, vertigo, and encephalopathy.
- The patient exhibited multifocal myoclonic jerks and conjugate ocular oscillations in random directions.
Findings:
- Electroencephalography (EEG) revealed eye movement artifacts during awake states and stage 2 sleep.
- The patient was diagnosed with opsoclonus-myoclonus syndrome (OMS), which persisted for 3 months before improving at 8 months.
Implications:
- West Nile virus encephalitis is identified as a potential cause of opsoclonus-myoclonus syndrome.
- The presence of EEG eye movement artifacts during stage 2 sleep warrants suspicion for OMS.
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