In Reply We thank Gallerini and colleagues for bringing to our attention a new case of opsoclonus associated with a gastric adenocarcinoma. The patient confirms the tight association of older age with a paraneoplastic etiology of the opsoclonus.1
As the authors mention, gastric cancer is rarely seen in patients with paraneoplastic opsoclonus who usually have breast or small-cell lung cancer.2 In addition to the previously reported cases reviewed by Gallerini and colleagues, we would include another case who also presented with Ma2 antibodies.3 Last, patients with opsoclonus and a high suspicion of an underlying tumor should be evaluated according to proposed guidelines to detect the occult neoplasm in paraneoplastic neurological syndromes.4
Graus F, Ariño H, Dalmau J. Opsoclonus-Myoclonus Syndrome in the Era of Neuronal Cell Surface Antibodies—Reply. JAMA Neurol. 2016;73(7):891. doi:10.1001/jamaneurol.2016.1164
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