Neonatal Opsoclonus

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Identifier 166-4
Title Neonatal Opsoclonus
Creator Shirley H. Wray, MD, PhD, FRCP
Affiliation (SHW) Professor of Neurology, Harvard Medical School; Director, Unit for Neurovisual Disorders, Massachusetts General Hospital, Boston, Massachusetts
Subject Neonatal Opsoclonus; Lid Nystagmus; Saccadic Oscillations
History This child was one of the first cases of opsoclonus that I saw with Dr. Cogan in the early 1970's. He carried a diagnosis of strabismus with deviation of the left eye. In this child, opsoclonus occurred as a transient phenomenon in an otherwise healthy infant. For a complete overview of opsoclonus in childhood, I recommend you review all the cases in this collection. ID 166-4 Neonatal Opsoclonus ID 166-6 Parainfectious Opsoclonus ID 166-12 Opsoclonus in the Dark ID 936-1 Neonatatal Opsoclonus ID 936-8 Paraneoplastic Opsoclonus Downbeat Nystagmus ID 166-12 is shown courtesy of Dr. John Leigh. It is a striking illustration of opsoclonus in the dark. Dr. Leigh made a film of the rapid multidirectional saccades by placing a light diode on the surface of the eyeball in a patient with opsoclonus. ID 936-8 is a very instructive case, previously published in the New England Journal of Medicine in 1995. The child presented with paraneoplastic opsoclonus due to an occult neuroblastoma. How to investigate a child with opsoclonus is fully outlined in ID936-8. Interested readers are referred to Pediatric Neuro-Ophthalmology. Editors: Brodsky MC, Baker RS, Hamed LM. Spinger-Verlag, New York, Inc. 1996.
Disease/Diagnosis Neonatal Opsoclonus
Clinical This baby has opsoclonus characterized by conjugate, multidirectional back to back rapid saccades without an intersaccadic interval. In this child opsoclonus occurred as a transient phenomenon in an otherwise healthy infant.
Presenting Symptom Abnormal eye movements
Ocular Movements Opsoclonus; Lid Nystagmus
Treatment None
Etiology Neonatal opsoclonus
Date 1972
References 1. Averbuch-Heller L, Remler BF. Opsoclonus. Semin Neurol 1996;16:21-26. http://www.ncbi.nlm.nih.gov/pubmed/8879053 2. Cogan DG. Ocular dysmetria: flutter like oscillations of the eyes and opsoclonus. Arch Ophthalmol 1954;51:318-335. http://www.ncbi.nlm.nih.gov/pubmed/13123617 3. Dyken P, Kolar O. Dancing eye dancing feet: Infantile polymyoclonia. Brain 1968; 91:305-320. http://www.ncbi.nlm.nih.gov/pubmed/5721932 4. Hankey GJ, Sadka M. Ocular flutter postural body tremulousness and CSF pleocytosis: a rare postinfectious syndrome. J Neurol Neurosurg Psychiatry 1987;50:1235-1236. http://www.ncbi.nlm.nih.gov/pubmed/3668576 5. Hoyt CS, Mousel DK, Weber AA. Transient supranuclear disorders of gaze in healthy neonates. Am J Ophthalmol 1980;89:708-711. http://www.ncbi.nlm.nih.gov/pubmed/7377270 6. Hoyt CS, Gelbart SS. Vertical nystagmus in infants with congenital ocular abnormalities. Ophthalmic Pediatr Genet 1984;4:155-162. http://www.ncbi.nlm.nih.gov/pubmed/6443616 7. Kinsbourne M. Myoclonic encephalopathy of infants. J Neurol Neurosurg Psychiatry 1962;25:2712-276. http://www.ncbi.nlm.nih.gov/pubmed/21610907 8. Kuban KC, Ephros MA, Freeman RL, Laffell LB, Bresnan MJ. Syndrome of opsoclonus-myoclonus caused by Coxsackie B3 infection. Ann Neurol 1983;13:69-71. http://www.ncbi.nlm.nih.gov/pubmed/6299176 9. Leigh RJ, Zee DS. Diagnosis of Nystagmus and Saccadic Intrusion. Chp 10:475-558. In: The Neurology of Eye Movements, Fourth Edition. Oxford University Press, NY. 2006. 10. Mitchell WG, Snodgress SR. Opsoclonus-ataxia due to childhood neural crest tumors: a chronic neurologic syndrome. J Child Neurol 1990;5:153-158. http://www.ncbi.nlm.nih.gov/pubmed/2345282 11. Morad Y, Benyamini OG, Avni I. Benign opsoclonus in preterm infants. Pediatr Neurol 2004;31:275-278. http://www.ncbi.nlm.nih.gov/pubmed/15464640 12. Nellhaus G. Abnormal head movements of young children. Dev Med Child Neurol 1983;25:384-389. http://www.ncbi.nlm.nih.gov/pubmed/6347776 13. Orzechowski K, Walichiewicz T. Przypadek operowanej torbieli srodpajeczy mozdika (operated cyst of the cerebellum) Licowski Tygodnik Lekurski 1913;18:219-227. 14. Pranzatelli MR. The neurobiology of the opsoclonus-myoclonus syndrome. Clin Neuropharmacol 1992;15:186-228. http://www.ncbi.nlm.nih.gov/pubmed/1394242 15. Pranzatelli MR, Tate ED, Kinsbourne M. Caviness VC, Mishra B. Forty-one year follow-up of childhood-onset opsoclonus-myoclonus-ataxia: cerebellar atrophy, multiphasic relapses and response to IVIG. Mov Disord 2002;17:1387-1390. http://www.ncbi.nlm.nih.gov/pubmed/12465092 16. Pranzatelli MR, Travelstead AL, Tate ED, Allison TJ, Verhulst SJ. CSF B-cell expansion in opsoclonus-myoclonus syndrome: a biomarker of disease activity. Mov Disord 2004:19:770-777. http://www.ncbi.nlm.nih.gov/pubmed/15254934 17. Pranzatelli MR, Tate ED, Travelstead AL, Longee D. Immunologic and clinical responses to rituximab in a child with opsoclonus-myoclonus syndrome. Pediatrics 2005;115:115-119. http://www.ncbi.nlm.nih.gov/pubmed/15601813 18. Rivner MH, Jay WM,Green JB, Dyken PR. Opsoclonus in hemophilus influenza meningitis. Neurology 1982;32:661-663. http://www.ncbi.nlm.nih.gov/pubmed/7201096 19. Shawkat FS, Harris CM, Wilson J, Taylor DSI. Eye movements in children with opsoclonus. Neuropaediatrics 1993;24:218-223. http://www.ncbi.nlm.nih.gov/pubmed/8232781 20. Wiest G, Safoschnik G, Schnaberth G, Mueller C. Ocular flutter and truncal ataxia may be associated with enterovirus infection. J Neurology 1997, 244:288-292. http://www.ncbi.nlm.nih.gov/pubmed/9178152 21. Wong AM, Musallam S, Tomlinson RD, Shannon P, Sharpe JA. Opsoclonus in three dimensions: oculographic, neuropathologic and modeling correlates. J Neurol Sci 2001;189:71-81. http://www.ncbi.nlm.nih.gov/pubmed/11535236
Language eng
Format video/mp4
Type Image/MovingImage
Source 16 mm Film
Relation is Part of 166-3, 166-6, 166-12, 936-1, 936-8
Collection Neuro-Ophthalmology Virtual Education Library - Shirley H. Wray Neuro-Ophthalmology Collection: https://novel.utah.edu/Wray/
Publisher North American Neuro-Ophthalmology Society
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah
Rights Management Copyright 2002. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright
ARK ark:/87278/s6pv9h0z
Setname ehsl_novel_shw
ID 188633
Reference URL https://collections.lib.utah.edu/ark:/87278/s6pv9h0z