A 26-year-old male, presented to us with complaints of fever for five days and breathlessness for one day. During the hospital stay, he developed myoclonic jerks in all four limbs, head titubation, and saccadomania. Magnetic resonance imaging (MRI) of the brain ruled out structural lesions and cerebro spinal fluid (CSF) analysis ruled out meningo-encephalitis. Weil Felix was strongly positive, OX K titres were one in 640, and IgM for scrub typhus was positive. He was treated with doxycycline for one week. On follow-up he was found to be doing well with resolution of opsoclonus myoclonus.
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