Rare neurological manifestation following hepatitis A infection: a report of 2 cases

Sumita Pal; Anushka Nag; Soumyadeep Sarkar

doi:10.18203/2349-3291.ijcp20250418

Authors

Sumita Pal Department of Pediatrics Medicine, Calcutta National Medical College, Beniapukur, Kolkata, West Bengal, India
Anushka Nag Department of Pediatrics Medicine, Calcutta National Medical College, Beniapukur, Kolkata, West Bengal, India https://orcid.org/0009-0005-6236-6256
Soumyadeep Sarkar Department of Pediatrics Medicine, Calcutta National Medical College, Beniapukur, Kolkata, West Bengal, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20250418

Keywords:

Opsoclonus myoclonus ataxia syndrome, Hepatitis A, Ataxia, Acute cerebellar ataxia, Postinfectious opsoclonus

Abstract

Hepatitis A is the leading cause of acute viral hepatitis in developing countries. Extra-hepatic manifestation is very rare occurrence in Hepatitis A. We report 2 cases, one developing Acute Cerebellar Ataxia and another Opsoclonus Myoclonus Ataxia syndrome (OMAS). The former presented with Ataxia of acute onset one week after Hepatitis A infection. The patient did not have any neurological complication and responded to conservative management. The second patient was a 7-year-old girl presented with behavioral abnormality, jerky eye movements and ataxia with myoclonus following a Hepatitis A infection one week ago. Patient was treated with pulse dose methyl prednisolone followed by oral prednisolone and showed a prompt response. Neurological manifestation following Hepatitis A is a rare phenomenon.

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References

Rossor TY, Khakoo EA. Diagnosis and management of opsoclonus-myoclonus-ataxia syndrome in children: an international perspective. Neurol Neuroimmunol Neuroinflamm. 2022;9:1153. DOI: https://doi.org/10.1212/NXI.0000000000001153

Kaninde A, Rai B, Katre M. P651 Transient acute cerebellitis with hepatitis a virus infection in a 3 years old child on nitrofurantoin prophylaxis. Arch Dis Child. 2019;104:409. DOI: https://doi.org/10.1136/archdischild-2019-epa.981

Sharma S, Prakash PR, Narayan A, Garg A, Wig N. Acute cerebellar ataxia: a rare association of hepatitis A infection. Ann Indian Acad Neurol. 2023;26(3):278-80. DOI: https://doi.org/10.4103/aian.aian_61_23

McCarthy VP, Zimmerman AW, Miller CA. Central nervous system manifestations of parainfluenza virus type 3 infections in childhood. Pediatr Neurol. 1990;6:197–201. DOI: https://doi.org/10.1016/0887-8994(90)90063-7

Desai SD, Gandhi FR, Vaishnav A. Opsoclonus myoclonus syndrome: a rare manifestation of dengue infection in a child. J Pediatr Neurosci. 2018;13(4):455-8. DOI: https://doi.org/10.4103/JPN.JPN_55_18

Kang BH, Kim JI. Opsoclonus-myoclonus syndrome associated with mumps virus infection. J Clin Neurol. 2014;10:272–5. DOI: https://doi.org/10.3988/jcn.2014.10.3.272

Naselli A, Pala G, Cresta F, Finetti M, Biancheri R, Renna S. Acute post-infectious cerebellar ataxia due to co-infection of human herpesvirus-6 and adenovirus mimicking myositis. Ital J Pediatr. 2014;40:98. DOI: https://doi.org/10.1186/s13052-014-0098-y

Tuthill D, Jones ERV. Acute cerebellar ataxia after subclinical hepatitis A infection. Pediatr Infect Dis J. 1996;15:546-7. DOI: https://doi.org/10.1097/00006454-199606000-00017

Dassan P, Clarke C, Sharp DJ. A case of poststreptococcal opsoclonus-myoclonus syndrome. Mov Disord. 2007;22:1490–1. DOI: https://doi.org/10.1002/mds.21513

Peter L, Jung J, Tilikete C, Ryvlin P, Mauguiere F. Opsoclonus-myoclonus as a manifestation of Lyme disease. J Neurol Neurosurg Psychiatry. 2006;77:1090–1. DOI: https://doi.org/10.1136/jnnp.2006.091728

Syrbe S, Merkenschlager A, Bernhard MK, Grosche J, Liebert UG, Hirsch W, et al. Opsoclonus-myoclonus syndrome after adenovirus infection. Springerplus. 2015;4:636. DOI: https://doi.org/10.1186/s40064-015-1429-1