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May 1989

Opsoclonus Secondary to an Epstein-Barr Virus Infection

Author Affiliations

Department of Neurology
Department of Neurochemistry, UCL Clinique St Jean 1000 Bruxelles, Belgium

Arch Neurol. 1989;46(5):480-481. doi:10.1001/archneur.1989.00520410014009

To the Editor.  —The term opsoclonus, coined by Orzechowski and Walichiewicz1 in 1913, denotes involuntary, irregular, chaotic, continual, and conjugate saccades of the eyes. Although the locus of lesion and pathophysiology are unknown, opsoclonus remains a distinctive disorder of ocular motility that is associated with a variety of diseases. The most frequent associations in adults are with postinfectious illness and paraneoplasia.We report a case of opsoclonus secondary to an Epstein-Barr virus (EBV) infection. The arguments for a viral origin are the EBV viral titers and the evidence of antibodies in the cerebrospinal fluid (CSF).

Report of a Case.  —A 71-year-old woman was admitted for acute onset of tremulousness, unsteadiness, vertigo, and oscillopsia. Neurologic examination showed truncal ataxia, occasional myoclonic jerk, and involuntary eye movements. The eye movements were irregular, continual, chaotic, conjugate, and arrhythmic. They were increased with eye closure and persisted in sleep. They were predominantly horizontal

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