key: cord-0847518-plovzheu
authors: Heald, Darion L.; Devine, Irisa M.; Smith, Roderic L.; Holsopple, Sarah A.T.; Arasmith, Jessica L.; Arnold, Robert W.
title: OPSOCLONUS AFTER COVID-19 IN AN INFANT
date: 2021-01-01
journal: Pediatr Neurol
DOI: 10.1016/j.pediatrneurol.2020.12.009
sha: d68687b5c2e48bacb8fb5e1731b860d3aaeeace6
doc_id: 847518
cord_uid: plovzheu

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Burr, et al report a toddler with encephalitis following COVID-19 1 . We observed another nerve disorder in an infant with SARS-CoV-2 infection.

Case Report: A 4-month-old female twin was admited to the pediatric inpatient ward with episodic chaotic eye movement and tongue thrusting.

The onset was one month after COVID-19 infection with brief, un-heralded conjugate eye movements in all directions 1-8 episodes per day, the longest lasting 7 minutes. The mother obtained smart phone videos of two episodes and provided written informed consent to share them(video link). She tried to halt or reduce the episodes by placing her hand over the eyes. Twin girls were born by C-section at 36 weeks after normal prenatal care including a normal 20-week ultrasound. At 5 weeks of age for cough and dyspnea she was treated and released from the emergency department however screening nasal swabs for COVID-19 in both twins and mother were positive. Her respiratory symptoms cleared in less than one week, but then mother observed "eye vibrations."

During her hospital admission, she was afebrile and interactive between episodes. Her neurologic exam was non-focal. Cranial nerves were intact. She had normal to mildly increased muscle tone, normal strength, reflexes and coordination. She was meeting her developmental milestones on time and did not have developmental regression.

Here neuro-eye exam was normal with steady fixation, reactive pupils, moderate hyperopic-astigmatism, and normal retinae without papilledema or optic nerve pallor. Video of opsoclonus with tongue thrusting: https://vimeo.com/pdimd/opsoclonus

N-Methyl-d-Aspartate Receptor Encephalitis Associated With COVID-19 Infection in a Toddler

Multifactorial analysis of opsoclonusmyoclonus syndrome etiology

Opsoclonus myoclonus ataxia syndrome (OMAS) in the setting of COVID-19 infection

Opsoclonus Myoclonus Ataxia Syndrome Related to the Novel Coronavirus (COVID-19)