Opsoclonus Myoclonus

Synonyms:

a.k.a. dancing eyes dancing feet syndrome

Diagnosis:

This is a clinical syndrome

Clinical features:

  • Age: 18 months to 6 years. Can occur in adults
  • Opsoclonus: rapid, involuntary, repetitive disorganised congugate eye movements in all directions of gaze. Can be confirmed by oculography: absent intersaccadic interval

Investigations to consider:

  • MRI: neuroblastoma
  • CT: lung cancer, Hodgkins disease/Hodgkins lymphoma, thyroid cancer
  • US thyroid: thyroid cancer
  • Mammography: breast cancer
  • LP & CSF analysis:
    • Brainstem encephalitis
    • PCR for whipple’s disease
    • Pleocytosis, raised IgG, increased protein
  • Other tests for whipple’s disease
  • Paraneoplastic antibodies: anti-Ri

Treatment:

Treat the underlying disorder
Steroids

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