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Adult paraneoplastic opsoclonus-myoclonus syndrome associated with antimitochondrial autoantibodies
Paraneoplastic opsoclonus-myoclonus syndrome (OMS) is a rare complication of cancer characterised by chaotic, synchronous eye movements (opsoclonus), spontaneous muscle jerks (myoclonus), and ataxia. In children OMS is almost exclusively associated with neuroblastoma, whereas in adults small cell lung cancer (SCLC) and breast cancer are the most frequent tumours associated with OMS.1,2 Some breast cancer patients with OMS have an antineuronal antibody called anti-Ri in the serum and CSF.1,2 In most patients with SCLC-associated OMS, antineuronal antibodies are not detected.1 Here we report the first case of SCLC-associated OMS with high titre antimitochondrial antibodies (AMA) in serum and CSF.
A 58 year old Caucasian woman developed a flu like syndrome, followed by eye movement disturbances three days later. On admission to our hospital, physical examination revealed disorientation, opsoclonus, myoclonus predominantly of the upper limbs, and severe limb and trunk ataxia. The deep tendon reflexes were normal and no paresis or sensory deficit could be found. Cranial CT and MRI scans and routine laboratory tests were normal. CSF examination revealed lymphocytic pleiocytosis, normal total …