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An Approach to a Patient with Gaze Disorder
Published in Vivek Lal, A Clinical Approach to Neuro-Ophthalmic Disorders, 2023
Opsoclonus is often referred to as saccadomania due to the nature of saccades that show large amplitude bursts in all directions. The intersaccadic interval is absent. They are always symptomatic. Opsoclonus persists during eye closure and sleep. Dysfunctional omnipause neurons leading to disinhibition of burst neurons may explain the underlying pathological mechanism. Opsoclonus, in conjunction with myoclonus, is seen as a paraneoplastic syndrome arising from neuroblastoma in children and tumor (small cell lung carcinoma and breast cancer) in adults [7].
Tumors of the Nervous System
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Opsoclonus is a disorder of ocular motility characterized by involuntary, rapid, irregular conjugate eye movements in both the vertical and horizontal plane. The patient experiences oscillopsia and myoclonic movements of the trunk and limbs. Cerebellar and other brainstem signs may be seen.
Neurotoxicity of Pesticides
Published in Ana Maria Osorio, Lynn R. Goldman, Proceedings from the Medical Workshop on Pesticide-Related Illnesses from the International Conference on Pesticide Exposure and Health, 2017
Matthew C. Keifer, Jordan Firestone
One organochlorine known as chlordecone (kepone) was responsible for an epidemic of poisonings at a manufacturing plant in Hopewell, Virginia, in the late 1970s. These cases included workers as well as some of their spouses. Neurological symptoms included nervousness, tremor, and opsoclonus.3 The toxicological mechanism of chlordecone is similar to that of the cyclodienes. The half-life of the chemical in blood is in the order of 165 days, but this can be foreshortened with the used of cholestyramine. Subsequent evaluation six years after initial diagnosis suggested that symptoms abated with reduction of blood levels of the pesticide.4
Opsoclonus Myoclonus Ataxia Syndrome Due to SARS-CoV-2
Published in Neuro-Ophthalmology, 2023
Josef Finsterer, Fulvio A. Scorza
Altogether, 29 articles reporting 45 patients with SARS-CoV-2 associated OMS/OMAS were retrieved (Table 1). Their ages ranged from 2 to 88 years (Table 1). Three patients were paediatric patients and the remainder adults. Gender was male in 32 patients and female in 13 patients. Opsoclonus alone or with other features was described in 30 patients. Myoclonus alone or together with other features was described in 43 patients. Opsoclonus was associated with myoclonus in 28 cases. Eighteen patients presented with opsoclonus, myoclonus, and ataxia; 11 patients with myoclonus and ataxia; ten patients with opsoclonus and myoclonus; and one patient with opsoclonus and ataxia (Table 1). Isolated myoclonus was described in four cases (Table 1), while isolated opsoclonus was reported in a single patient (Table 1). In 11 patients the OMS/OMAS was associated with cognitive impairment. One patient was extensively tested by means of the Wechsler Intelligence Scale for Children – Fourth Edition (WISC-IV) test, showing an inhomogeneous cognitive profile (verbal comprehension index 95, perceptional reasoning 56, working memory index 70, processing speed index: 47) resulting in an intelligence quotient of 58 (Table 1).
Serum Biomarkers in Neuro-Ophthalmology: When to Test
Published in Seminars in Ophthalmology, 2021
Devon A. Cohen, Ryan Gise, Eric D. Gaier
Opsoclonus (high-frequency, conjugate, and chaotic multidirectional saccadic movements) and myoclonus (involuntary sudden jerking movements of the limbs) are hallmark features of opsoclonus–myoclonus syndrome (OMS), which is strongly associated with malignancy.45–48 In the pediatric population, OMS manifests in the context of neuroblastoma in 50% of cases (with the remainder believed to be post-infectious).45,49,50 In adults, OMS is most commonly associated with: small cell lung cancer, ovarian cancer, and breast cancer.51,52 Opsoclonus is suspected to result from antibody-mediated dysfunction of omnipause neurons that gate saccadic eye movement).51,53
Opsoclonus myoclonus and ataxia syndrome with supraventricular tachycardia
Published in Baylor University Medical Center Proceedings, 2023
Sydney Garner, Alec Giakas, Katherine Holder, Bernardo Galvan, Hollie Edwards
After completion of treatment with IVIG and dexamethasone, the patient’s opsoclonus completely resolved. His myoclonus was no longer apparent when laying supine, but he did have infrequent, subtle jerks of his arms and trunk when held in a sitting position. After two more episodes of SVT, he was started on digoxin. The patient was discharged on propranolol and digoxin. Repeat urine VMA and HVA levels were slightly elevated secondary to suspected dilution. All metabolic laboratory tests that were sent out returned with normal results. An outpatient meta-iodobenzylguanidine scan revealed a normal distribution of radiotracer without uptake suspicious for a mass.