Neonatal Opsoclonus

Update item information
Identifier 166-4
Title Neonatal Opsoclonus
Ocular Movements Opsoclonus; Lid Nystagmus
Creator Shirley H. Wray, M.D., Ph.D., FRCP, Professor of Neurology Harvard Medical School, Director, Unit for Neurovisual Disorders, Massachusetts General Hospital
Contributor Primary Shirley H. Wray, MD, PhD, FRCP, Professor of Neurology, Harvard Medical School; Director, Unit for Neurovisual Disorders, Massachusetts General Hospital
Subject Neonatal Opsoclonus; Lid Nystagmus; Saccadic Oscillations
Presenting Symptom Abnormal eye movements
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.
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.
Etiology Neonatal opsoclonus
Disease/Diagnosis Neonatal Opsoclonus
Treatment None
References 1. Averbuch-Heller L, Remler BF. Opsoclonus. Semin Neurol 1996;16:21-26. 2. Cogan DG. Ocular dysmetria: flutter like oscillations of the eyes and opsoclonus. Arch Ophthalmol 1954;51:318-335. 3. Dyken P, Kolar O. Dancing eye dancing feet: Infantile polymyoclonia. Brain 1968; 91:305-320. 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. 5. Hoyt CS, Mousel DK, Weber AA. Transient supranuclear disorders of gaze in healthy neonates. Am J Ophthalmol 1980;89:708-711. 6. Hoyt CS, Gelbart SS. Vertical nystagmus in infants with congenital ocular abnormalities. Ophthalmic Pediatr Genet 1984;4:155-162. 7. Kinsbourne M. Myoclonic encephalopathy of infants. J Neurol Neurosurg Psychiatry 1962;25:2712-276. 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. 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. 11. Morad Y, Benyamini OG, Avni I. Benign opsoclonus in preterm infants. Pediatr Neurol 2004;31:275-278. 12. Nellhaus G. Abnormal head movements of young children. Dev Med Child Neurol 1983;25:384-389. 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. 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. 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. 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. 18. Rivner MH, Jay WM,Green JB, Dyken PR. Opsoclonus in hemophilus influenza meningitis. Neurology 1982;32:661-663. 19. Shawkat FS, Harris CM, Wilson J, Taylor DSI. Eye movements in children with opsoclonus. Neuropaediatrics 1993;24:218-223. 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. 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.
Relation is Part of 166-3, 166-6, 166-12, 936-1, 936-8
Publisher Spencer S. Eccles Health Sciences Library, University of Utah
Date 1972
Type Image/MovingImage
Format video/mp4
Source 16 mm Film
Rights Management Copyright 2002. For further information regarding the rights to this collection, please visit:
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah, 10 N 1900 E, SLC, UT 84112-5890
Collection Neuro-ophthalmology Virtual Education Library: NOVEL
Language eng
ARK ark:/87278/s6pv9h0z
Setname ehsl_novel_shw
Date Created 2008-09-05
Date Modified 2017-02-22
ID 188633
Reference URL