The opsoclonus-myoclonus syndrome may be found in patients with an underlying carcinoma.
Clinical features
(1) opsoclonus (ocular flutter): nonrhythmic vertical or horizontal oscillations of the eyes (multidirectional saccades)
(2) myoclonus of muscles in the head, trunk and limbs
(3) ataxia
Associated carcinomas:
(1) small cell lung cancer
(2) breast cancer
(3) ovarian cancer
(4) neuroblastoma
Laboratory testing:
(1) Many patients are seronegative for autoantibodies. Some patients may have anti-neuronal antibodies (anti-Hu, anti-Ri, anti-Yo, anti-CV2, anti-Ma1/2, etc), especially those targeting postsynaptic density.
Treatment of the underlying tumor may slow progression or reverse the syndrome. In children immunotherapy (IVIG, rituximab, etc) may help.
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