A 26-year-old female presented with complaints of worsening bilateral hand tremors, ataxia, intermittent myoclonus, vertigo, and opsoclonus. These symptoms began after six weeks following her third healthy child’s delivery. The patient had no history of serious medical issues like autoimmune diseases. The patient was initiated on intravenous methylprednisolone followed by intravenous immunoglobulin (IVIG). In 4 months, the symptoms returned. Additional testing revealed a new enhancing lesion in the MRI (Magnetic Resonance Imaging) brain and positive MOG-IgG (myelin oligodendrocyte glycoprotein- Immunoglobulin). The patient was switched to maintenance IVIG and then to rituximab.
Results
b) Rituximab
Opsoclonus myoclonus syndrome is a rare neuroimmunological disorder in children and adults. Symptoms include rapid multi-directional conjugate eye movements (opsoclonus), tremors, myoclonus, and cerebral ataxia. Rituximab appears to be a safe and efficacious therapy for opsoclonus myoclonus syndrome.
