poster 225: opsoclonus-myoclonus syndrome associated with hepatitis b infection: a case report

surgery, outline realistic expectations of recovery, and pro-vide neuromuscular re-education.Keywords: Rehabilitation, Spinal cord injury, Brachialplexopathy.

Poster 224

Obesity and Disability.Paolo Capodaglio, MD (Istituto Auxologico Ital-iano, IRCCS, Verbania, Italy); Marco Cavigioli;Francesco Menegoni; Luca Vismara.

Disclosures: P. Capodaglio, None.Objective: Obesity is frequently associated with variousmusculoskeletal disorders including impairment of the spineand low back pain (LBP). Chronic musculoskeletal condi-tions impact on the subjects’ capacity to perform daily lifeactivities eventually leading to disability. The role of obesityin the disablement process needs further scientific evidence.The aim of our study was to provide evidence of a directcorrelation between body weight and disability.Setting: Hospital-based study.Participants: 77 obese patients (BMI 41 � 7 kg/m2, age44 � 11 years) have been selected: 53 with non-specific lowback pain (nsLBP), 12 with specific low back pain (sLBP) and12 with no pain (NP).Main Outcome Measures: Pain was measured with theVAS (0-100) scale1. Disability was measured with the Rolandand Morris Disability Questionnaire (Rm) 2 and theOswestry Low Back Pain and Disability Questionnaire (O) 3.VAS, Rm and O were considered ordinal variables, thus weused non-parametric tests: Spearman rank order correlations(P�.05) for the correlations and Mann Whitney U-Test forcomparison between groups.Results: The strongest correlation was found between bodyweight and disability, as measured by O, in sLBP patients(R � 0.74, P � .005). In nsLBP a significant but lowercorrelation (R � .35, P � .01) was found. A significantcorrelation (R � .24, P � .036) was evident when all LBPpatients were considered, but no correlation was found in NPobese subjects.Conclusions: Body weight appears to have a fundamentalrole in the onset of LBP and a direct correlation with thedisablement process.Keywords: Low back pain, Disability, Obesity.

Poster 225

Opsoclonus-Myoclonus Syndrome Associatedwith Hepatitis B Infection: A Case Report.David Ronin, (Lutheran General Hospital, ParkRidge, IL); Lloyd S. Davis, MD; Susan Lis, MD;Amy Sun, MD.

Disclosures: D. Ronin, None.Patients or Programs: We describe a case of a 44-year-old man with no significant medical history who was admit-ted to an acute care hospital with sudden onset of dizziness,horizontal nystagmus and truncal ataxia.

Program Description: Extensive work-up for underly-ing malignancy, collagen vascular disease and infectious pro-cess was negative. Based on clinical presentation the patientwas diagnosed with opsoclonus-myoclonus syndrome(OMS).Setting: Tertiary hospital based acute care rehabilitationunit.Results: Infectious work- up was negative for cytomegalo-virus, Epstein-Barr virus or HIV. The patient was started onhigh-dose IV steroids. Subsequently he was transferred to therehabilitation unit of the hospital. Liver function tests weredone. There was slight increase in ALT, 99 units/L. Hepatitisscreen was positive for hepatitis B infection. Hepatitis B DNAviral load was high at 7.6 (42,100,000 IU/mL). Normal levelis less than 1.6. Patient’s functional status significantly im-proved. Entecavir was going to be used to treat hepatitis Binfection as an outpatient.Discussion: OMS is a rare debilitating disorder affectingchildren and adults. Underlying cause may involve infectionsor occult malignancy. Etiology of symptoms in OMS syn-drome is postulated to be immune-mediated response di-rected against a select group of neurons. Opsoclonus isassociated with impairment of pause cells in pontine reticularformation. Ataxia, truncal and limb myoclonus are due toloss of cerebellar neurons. Identification of actual microor-ganism in OMS is extremely rare. Reported viral infectionsinclude cytomegalovirus and Epstein-Barr virus. This is thefirst case, to our knowledge, of OMS associated with hepatitisB virus.Conclusions: We conclude that hepatitis B virus shouldbe included in differential diagnosis of OMS. Early treatmentmay significantly improve patient’s outcome.Keywords: Rehabilitation, Opsoclonus-myoclonus syn-drome, Hepatitis B virus.

Poster 226

Ovarian Vein Thrombophlebitis (OVT), a RareCause of Persistent Fever in the Setting ofAcute Inpatient Rehabilitation: A Case Report.Sangmin Ahn, MD (Baylor College of Medicine,Houston, TX); Pari Azari; John S. Harrell, MD.

Disclosures: S. Ahn, None.Patients or Programs: A 30-year-old woman with lefthemiparesis secondary to a right basal ganglia hematoma dueto eclampsia, status post emergent cesarean section and rightfrontotemporal craniotomy with evacuation.Program Description: A 30-year-old woman at 38 weekgestation presented with seizures secondary to eclampsia.Seizures were controlled with magnesium sulfate but thepatient sustained a left basal ganglia intracerebral hemor-rhage with resultant hemiparesis. Cesarean section followedby right frontotemporal craniotomy with evacuation wasemergently performed. She was transferred to inpatient reha-bilitation for functional deficits related the hemiparesis. Per-sistent fever with leukocytosis developed on admission withunremarkable review of systems except headache and sore-

S201PM&R Vol. 1, Iss. 9S, 2009