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Opsoclonic CerebellopathyA Paraneoplastic Syndrome Responsive to Thiamine
Paul A. Nausieda, MD;
Caroline M. Tanner, MD;
William J. Weiner, MD
Arch Neurol. 1981;38(12):780-781.
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Cerebellar dysfunction associated with opsoclonic eye movements has been described as a paraneoplastic effect of malignant neoplasms and may be the initial symptom in some cases. This neurologic symptom complex is rare and has been reported in association with carcinomas of the lung,1.2 breast,3 and uterus4 in adults. In children, it is associated with neural crest tumors, particularly neuroblastoma.5-7 Like most paraneoplastic syndromes, the pathogenesis of this disorder is unknown. No specific therapy for this syndrome is known other than treatment of the underlying malignancy.
We studied a patient in whom an isolated subacute cerebellar syndrome and opsoclonus developed, which appeared 14 months after apparently successful chemotherapy of an oropharyngeal carcinoma. Although the initial clinical impression was that of paraneoplastic syndrome related to recurrence of the primary neoplasm, no evidence of recurrence was apparent. An empiric trial of thiamine hydrochloride led to dramatic improvement in clinical
. . . [Full Text PDF of this Article]
Author Affiliations
From the Departments of Neurological Sciences (Drs Nausieda, Tanner, and Weiner) and Pharmacology (Drs Nausieda and Weiner), Rush-Presbyterian St Lukes Medical Center, Chicago.
Footnotes
Accepted for publication April 16, 1981.
Reprint requests to Department of Neurological Sciences, 1725 W Harrison St, Suite 915, Chicago, IL 60612 (Dr Nausieda).
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