Opsoclonus–myoclonus Syndrome Associated With Benign Ovarian Teratoma

Treatment responsive opsoclonus-ataxia associated with ovarian teratoma

“…Fitzpatrick et al 5 described a 15-year-old girl with opsoclonus–myoclonus syndrome associated with benign ovarian teratoma but without anti-NMDA receptor antibodies, showing similarities to our case. The similarities included: (1) occurrence in young woman with mature ovarian teratoma; (2) opsoclonus and ataxia with a subacute onset; (3) normal MRI; (4) absence or minimal inflammatory response in CSF; (5) absence of antineuronal antibodies, including anti-NMDA receptor antibodies; and (6) response to tumour resection and immunotherapy, including corticosteroids and intravenous immunoglobulins.…”

Opsoclonus-Myoclonus Syndrome in Anti-N-Methyl-D-Aspartate Receptor Encephalitis

“…Kawachi, MD, PhD, et al, unpublished data, 2009) 4. Our study shows that opsoclonus-myoclonus may overlap with the syndrome described in anti-NMDAR encephalitis in which case patients do have NMDAR antibodies.…”

“…Two cases of opsoclonus-myoclonus syndrome have been reported with benign ovarian teratoma, but anti-NMDAR antibodies were not found (I.T.Y. Kawachi, MD, PhD, et al, unpublished data, 2009) 4. Herein we describe a patient who developed opsoclonus-myoclonus syndrome and ataxia along with an otherwise typical presentation of anti-NMDAR encephalitis.…”

Opsoclonus as a suspected paraneoplastic syndrome of endometrial cancer

“…The temporal alignment between the improvement in her neurologic function and the treatment of her cancer strongly suggests a paraneoplastic phenomenon. A review of the English-language literature reveals three cases of OMS in association with ovarian neoplasms, and all three patients’ neurologic symptoms were ameliorated by anti-neoplastic therapy: a 15-year-old with a mature teratoma and a negative paraneoplastic panel, whose symptoms improved after surgery; 10 a 45-year-old with epithelial ovarian carcinoma and negative PCA-1, ANNA-1, and ANNA-2 antibodies, whose neurologic status improved after surgery and chemotherapy; 11 and a 58-year-old with anaplastic adenocarcinoma of the ovarian duct and seropositivity for ANNA-2, whose symptoms improved after surgery, although she also received steroids. 12 Taken together, our case plus these published accounts would indicate that some antigen(s) within the Müllerian epithelium can incite an immune response that may elicit a reversible targeted dysfunction of an inhibitory component of the brainstem oculomotor system.…”