Objective: To identify the most frequent movement disorders and their clinical features, as well as the most common infectious etiologies in immunocompromised non-HIV patients, based on available literature.

Background: Movement disorders (MDs) can occur in immunocompromised patients as rare but clinically significant manifestations of infectious diseases. While extensively studied in HIV-positive populations, data on non-HIV patients are limited. Early recognition may aid timely diagnosis and management.

Method: A systematic search was conducted in PubMed using terms related to movement disorders, infections, and immunosuppression, excluding HIV. The search yielded 100 records, of which 24 were included after screening. Study selection was performed independently by two reviewers, with disagreements resolved by consensus or by consultation with a third reviewer. Data on demographics, cause of immunosuppression, type of infection, movement disorder phenomenology, and outcomes were extracted.

Results: Thirty-six patients were analyzed; age and sex were unavailable in 16 (44%). Among the remaining patients, 13 (65%) were female, with a mean age of 56.4 years (36–79). Immunosuppression was mainly related to solid organ or hematologic transplantation (39%), lymphoma (17%), and leukemia (11%). Infections were predominantly viral (88%), including West Nile virus encephalitis (39%), JC virus causing progressive multifocal leukoencephalopathy (22%), and human herpesvirus-6 encephalitis (6%); less frequent causes were cryptococcosis (6%) and cerebral nocardiosis (6%). The most common movement disorders were ataxia (52%), myoclonus (39%), and tremor (17%), with other phenotypes including parkinsonism and opsoclonus–myoclonus syndrome.

Conclusion: Infections in immunocompromised non-HIV patients cause diverse movement disorders. Early clinical identification of these disorders and their etiologies is crucial to guide management and support the diagnosis of systemic infections. Prospective studies are needed to better characterize epidemiology, pathophysiology, and optimal treatment strategies in this population.

Infection-Related Movement Disorders Overview

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