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[Opsoclonus-myoclonus syndrome in the adult. 4 cases]
Abstract:
Four cases of opsoclonus in adults are reported. In all cases, it was associated with myoclonus and cerebellar syndrome. In 2 cases, the clinical and biological picture was suggestive of an infectious origin, and the patients recovered. The last cases are paraneoplastic opsoclonus revelating a pulmonary carcinoma and a breast cancer. The two patients died from metastasis after a transient improvement of ocular disorder. The pathophysiology of opsoclonus is discussed.
Insights
Opsoclonus in adults, often linked with myoclonus and cerebellar issues, can stem from infections or paraneoplastic syndromes. Early diagnosis and treatment are crucial for managing this rare neurological disorder.
Area of Science:
- Neurology
- Neuro-oncology
- Infectious Diseases
Background:
- Opsoclonus is a rare neurological disorder characterized by involuntary, rapid, multidirectional eye movements.
- It is frequently associated with myoclonus and cerebellar dysfunction, collectively termed opsoclonus-myoclonus syndrome (OMS).
Observation:
- This report details four adult cases of opsoclonus.
- All patients presented with associated myoclonus and cerebellar syndrome.
- Two cases showed clinical and biological signs suggestive of an infectious etiology, leading to recovery.
Findings:
- Two cases of opsoclonus were paraneoplastic, revealing underlying pulmonary carcinoma and breast cancer.
- These patients experienced transient improvement in ocular symptoms but ultimately succumbed to metastatic disease.
- The findings highlight the diverse origins of opsoclonus in adults.
Implications:
- Opsoclonus in adults warrants thorough investigation for both infectious and paraneoplastic causes.
- Identifying an underlying malignancy is critical for prognosis, even with initial ocular symptom improvement.
- Further research into the pathophysiology of opsoclonus may reveal novel therapeutic targets.