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Background-Though most of children with Opsoclonus Myoclonus Ataxia Syndrome (OMAS) are para-neoplastic, isolated cases of post-infectious OMAS have been described.

Aim and Objectives-We retrospectively analysed all children with OMAS from May 2015 to July 2018 for post-infectious OMAS.

Results- A total of four children with post-infectious OMAS were identified from a total of thirteen children with OMAS. The median age was three years and three out of thirteen were girls. The four children were diagnosed with scrub typhus encephalitis, aseptic meningitis, and two children with acute disseminated encephalomyelitis. All four had opsoclonus, ataxia and behavioural abnormalities; three children had sleep disturbances, while myoclonus was present in only one child. Two children with scrub typhus and aseptic meningitis were treated with antibiotics alone, while third child was treated with pulse methylprednisolone and fourth child was treated with pulse methylprednisolone and intravenous immunoglobulin. All four required only acute symptomatic treatment and no maintenance immunotherapy was required thereafter. Evaluation for tumour was negative in all children. The first three children remain functionally normal after 3-9 months of follow up while the fourth child has mild residual opsoclonus after 1 month of follow up.

Conclusion- In tropical countries, post infectious OMAS constitute a significant proportion of children with OMAS and all children with OMAS should be subjected to detailed microbiological evaluation, cerebrospinal fluid analysis for infection and neuro-radiology of brain to rule out demyelination, in addition to evaluation for neoplastic aetiology.

Rickettsiae; scrub; demyelination; acute disseminated encephalomyelitis; meningitis;