Opsoclonus-myoclonus-ataxia syndrome presenting in Enugu, Southeast Nigeria: A case report

Abstract

Opsoclonus – myoclonus- ataxia syndrome is an extremely rare neurological condition of probable autoimmune aetiology. It has not been previously described in medical literature from Nigeria and West Africa. This is a case report of a 43- year old Nigerian woman who presented to the University of Nigeria Teaching Hospital Enugu Emergency Department in July 2018 with a 5 weeks history with vertigo, diplopia, dancing eyes, muscular twitches and incoordination two weeks after a caesarean section complicated by intra-operative bleeding. No other significant medical history. She had been managed as a case of cerebellar haemorrhage before referral to the Neurology Unit. On examination she was lucid, had normal vital signs, opsoclonus, motor ataxia and myoclonus affecting the left face as well as left upper extremity. Investigations done were normal except for reduced cerebrospinal fluid ( CSF) protein. Her symptoms responded substantially to prednisolone and clonazepam. The relevant literature was reviewed. Opsoclonus myoclonus ataxia syndrome though rarely described in Africans may occur and may be misdiagnosed by inexperienced physicians leading to undesirable consequences.