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BMJ Case Reports 2017; doi:10.1136/bcr-2017-219859
  • CASE REPORT

Postintervention acute opsoclonus myoclonus syndrome

  1. Josanne Aquilina3
  1. 1 Department of Neurosciences, Mater Dei Hospital, Attard, Malta
  2. 2 Department of Neuroscience, Mater Dei Hospital, Msida, Malta
  3. 3 Department of Neurology, Mater Dei Hospital, Msida, Malta
  1. Correspondence to Dr Annelise Aquilina, annie.aquilina{at}gmail.com
  • Accepted 5 April 2017
  • Published 21 April 2017

Summary

Opsoclonus myoclonus syndrome (OMS) is a rare, neurological condition affecting 1 in 10 000 000 people annually. Opsoclonus, defined as involuntary rapid, multivectorial oscillations of the eyes, together with ataxia and myoclonus are usually present. OMS may be paraneoplastic: often associated with occult neuroblastoma in childhood and with breast carcinoma or small cell lung carcinoma in adults. Other aetiologies include viral or toxic agents. The pathogenesis is thought to be immune mediated. A 37-year-old woman with previous inflammatory cranial mononeuropathies was admitted for elective dilatation and curettage (D&C). Immediately after she complained of left-sided paraesthesia and later became disoriented, with incoherent speech, inability to obey commands, opsoclonus of the eyes and myoclonic jerks. Investigations including onconeuronal antibodies, cerebrospinal fluid analysis, and imaging were normal. She was treated with intravenous methylprednisolone with rapid improvement. Previous surgeries with anaesthesia were uncomplicated. The anaesthetic agents used for the D&C were fentanyl and propofol.

Footnotes

  • Contributors AA wrote the case report with the guidance of the firm responsible for the patient's care. Resident specialist, neurology: ND. Consultant neurologist: JA.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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