Movement Disorders and Cerebellar Syndromes Associated with Mycoplasma pneumoniae Infection: A Systematic Review.
Level 4 - case-series / case-control
Systematic review of published case reports and case series
PubMed 42237532 · doi:10.1002/mdc3.70702
What was done
A systematic review (PROSPERO CRD420251243903) was conducted following PRISMA guidelines to characterize movement disorders and cerebellar syndromes linked to Mycoplasma pneumoniae. Individual patient data were extracted from published case reports, case series, and three pediatric cohorts, assessing clinical features, CSF findings, neuroimaging, treatment approaches, and outcomes.
What was found
Across 42 individual published cases, a preceding respiratory illness was documented in 69.0%, with manifestations being parainfectious in 54.8% and post-infectious in 28.6%. The most frequent clinical presentations were cerebellar ataxia/cerebellitis (38.1%) and opsoclonus-myoclonus-ataxia syndrome (26.2%). CSF pleocytosis was observed in 54.8%, and neuroimaging was normal in 50.0% (abnormalities were localized to the cerebellum or basal ganglia). Treatment included antibiotics alone in 35.7% and immunotherapy with or without antibiotics in 45.3%. Complete or near-complete recovery occurred in 83.4% of cases. Three pediatric cohorts also confirmed cerebellar ataxia as the universal presentation with predominantly favorable outcomes.
Why it matters
This review collates rare parainfectious and post-infectious central nervous system complications of Mycoplasma pneumoniae, outlining the typical phenotypes and demonstrating a generally favorable prognosis with antimicrobial or immunomodulatory therapy.
Limits
The findings are derived entirely from retrospective case reports and series, which are subject to substantial reporting and publication bias. The total sample size is small (42 individual cases), and treatment strategies were not standardized or prospectively controlled.
Cited by
- supports Mycoplasma infections can localize to and affect the basal ganglia.