Movement disorders clinical practice · 2026
Movement Disorders and Cerebellar Syndromes Associated with Mycoplasma pneumoniae Infection: A Systematic Review.
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Garg Ravindra Kumar, Pandey Shweta, Jain Amita, Karoli Ritu, Paliwal Vimal Kumar, Singhal Sanjay
Аннотация
BACKGROUND: Mycoplasma pneumoniae is a well-recognized respiratory pathogen increasingly associated with diverse neurological manifestations beyond pulmonary disease involvement.
OBJECTIVES: To evaluate movement disorders and cerebellar syndromes linked to Mycoplasma pneumoniae, focusing on clinical relevance, diagnosis, and management challenges.
METHODS: A systematic review of published case reports and case series was conducted following PRISMA guidelines. Individual patient data were extracted for demographic characteristics, clinical features, diagnostic confirmation, cerebrospinal fluid findings, neuroimaging, treatment strategies, outcomes, and proposed pathophysiological mechanisms. The protocol was prospectively registered with PROSPERO under the identifier PROSPERO 2025 CRD420251243903.
RESULTS: A total of 42 published cases of Mycoplasma pneumoniae-associated movement disorders were analyzed. A preceding respiratory illness was documented in 69.0%, and neurological manifestations were mainly parainfectious (54.8%) or post-infectious (28.6%). Cerebellar ataxia/cerebellitis (38.1%) and opsoclonus-myoclonus-ataxia syndrome (26.2%) were the most frequent phenotypes. Cerebrospinal fluid pleocytosis occurred in 54.8%, while neuroimaging was normal in 50.0%; abnormalities predominantly involved the cerebellum or basal ganglia. Antibiotics alone were used in 35.7%, and 45.3% received immunotherapy with or without antibiotics. Complete or near-complete recovery occurred in 83.4%. Three pediatric cohorts confirmed the rarity of these disorders, with cerebellar ataxia as the universal phenotype and predominantly favorable outcomes.
CONCLUSIONS: Movement disorders associated with or temporally related to Mycoplasma pneumoniae infection are uncommon and appear predominantly immune mediated, with cerebellar ataxia and opsoclonus-myoclonus-ataxia syndrome being the most frequent presentations. Most cases occur in a parainfectious or post-infectious setting and show favorable outcomes with timely antibiotic and immunomodulatory therapy, although residual deficits may persist in a minority.
OBJECTIVES: To evaluate movement disorders and cerebellar syndromes linked to Mycoplasma pneumoniae, focusing on clinical relevance, diagnosis, and management challenges.
METHODS: A systematic review of published case reports and case series was conducted following PRISMA guidelines. Individual patient data were extracted for demographic characteristics, clinical features, diagnostic confirmation, cerebrospinal fluid findings, neuroimaging, treatment strategies, outcomes, and proposed pathophysiological mechanisms. The protocol was prospectively registered with PROSPERO under the identifier PROSPERO 2025 CRD420251243903.
RESULTS: A total of 42 published cases of Mycoplasma pneumoniae-associated movement disorders were analyzed. A preceding respiratory illness was documented in 69.0%, and neurological manifestations were mainly parainfectious (54.8%) or post-infectious (28.6%). Cerebellar ataxia/cerebellitis (38.1%) and opsoclonus-myoclonus-ataxia syndrome (26.2%) were the most frequent phenotypes. Cerebrospinal fluid pleocytosis occurred in 54.8%, while neuroimaging was normal in 50.0%; abnormalities predominantly involved the cerebellum or basal ganglia. Antibiotics alone were used in 35.7%, and 45.3% received immunotherapy with or without antibiotics. Complete or near-complete recovery occurred in 83.4%. Three pediatric cohorts confirmed the rarity of these disorders, with cerebellar ataxia as the universal phenotype and predominantly favorable outcomes.
CONCLUSIONS: Movement disorders associated with or temporally related to Mycoplasma pneumoniae infection are uncommon and appear predominantly immune mediated, with cerebellar ataxia and opsoclonus-myoclonus-ataxia syndrome being the most frequent presentations. Most cases occur in a parainfectious or post-infectious setting and show favorable outcomes with timely antibiotic and immunomodulatory therapy, although residual deficits may persist in a minority.