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Comment & Response
April 2018

Opsoclonus-Myoclonus Syndrome—Additional Clinical Considerations

Author Affiliations
  • 1Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
JAMA Otolaryngol Head Neck Surg. 2018;144(4):387-388. doi:10.1001/jamaoto.2017.3427

To the Editor We read with interest the report by Hsu et al1 describing a 39-year-old woman with opsoclonus-myoclonus syndrome (OMS). Although an intriguing case, several aspects of the treatment should be addressed for others who may encounter this condition.

As noted by the authors, paraneoplastic OMS is a leading diagnostic consideration in adult-onset disease, particularly in association with lung or breast cancer.2,3 However, no imaging to screen for systemic malignant abnormality is reported in this case. Although this patient may have been considered too young for carcinoma-associated OMS, paraneoplastic OMS in early adulthood may occur secondary to systemic teratoma.4 Any young adult woman with OMS should therefore be investigated for teratoma of the ovary, since removal of the teratoma may be required in combination with immunotherapy to achieve sustained disease remission.4

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