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Immunotherapy responsive SARS-CoV-2 infection exacerbating opsoclonus myoclonus syndrome

Authors
  • Wiegand, Sarah E.1
  • Mitchell, Wendy G.1, 2
  • Santoro, Jonathan D.1, 2
  • 1 Division of Neurology, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA 90027, USA
  • 2 Department of Neurology, Keck School of Medicine at the University of Southern California, Los Angeles, CA 90033, USA
Type
Published Article
Journal
Multiple Sclerosis and Related Disorders
Publisher
Elsevier B.V.
Publication Date
Feb 23, 2021
Volume
50
Pages
102855–102855
Identifiers
DOI: 10.1016/j.msard.2021.102855
PMID: 33677410
PMCID: PMC7899919
Source
PubMed Central
Disciplines
  • Correspondence
License
Unknown

Abstract

The global pandemic of SARS-CoV-2 has been known to have diverse neurologic complications among adult patients. The neurologic effects of SARS-CoV-2 in the pediatric population is poorly described, especially in those with rare underlying neurologic conditions. We describe the first known case of SARS-CoV-2 in a pediatric patient with refractory opsoclonus-myoclonus syndrome. A 25-month-old female with progressive opsoclonus-myoclonus syndrome secondary to metastatic neuroblastoma status-post resection and chemotherapy presented with worsening opsoclonus, tremor, and breakthrough seizures. She had no fever or respiratory symptoms at presentation. Urine catecholamines were unchanged, with low suspicion for tumor recurrence. She was found to have SARS-CoV-2 via nasopharnygeal PCR assay. She received intravenous immunoglobulin and dexamethasone therapy with improvement in opsoclonus-myoclonus syndrome symptoms and was discharged home at her neurologic baseline. Patients with opsoclonus-myoclonus syndrome may present with exacerbation of symptoms in the context of SARS-CoV-2. This case describes a sentinel report of a child with opsoclonus-myoclonus syndrome presenting with worsening symptoms with concomitant SARS-CoV-2. Improvement in symptoms was achieved with standard of care therapies.

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