Learning Objectives
- Differentiating OMAS from mimicking conditions, particularly acute cerebellar ataxia.
- Identifying the most sensitive tests for detecting neuroblastoma in OMAS.
- Developing a treatment strategy for OMAS.
- Recognizing historically poor cognitive and behavioral outcomes and how modern treatment strategies improve these outcomes.
- Understanding current challenges in identifying a biomarker for OMAS and ongoing research approaches.
Clinical Presentation and Diagnosis
Case Example
- Patient: 21-month-old female, initially diagnosed with acute cerebellar ataxia after upper respiratory infection.
- Symptoms: Severe gait ataxia, brief fluttering eye movements.
- Initial MRI: Normal, treated with IV methylprednisolone; relapsed twice.
- Further Symptoms: Slurred speech, disturbed sleep, increased tantrums, rare opsoclonus.
- Final Diagnosis: OMAS.
Acute Cerebellar Ataxia (Differential Diagnosis)
- Autoimmune cerebellar disorder predominantly presenting as acute gait ataxia.
- Typically post-infectious, average age 4–6 years, slight male predominance.
- Normal MRI; rapid recovery without relapse.
Acute Cerebellitis (Differential Diagnosis)
- Symptoms: Headache, vomiting, altered mental status.
- Abnormal MRI with cerebellar inflammation; potentially life-threatening.
Distinguishing OMAS from Acute Cerebellar Ataxia
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