Among paraneoplastic neurologic disorders (PND), opsoclonus-myoclonus syndrome, so-called “dancing eye syndrome,” is a rare disorder combining multivectorial eye movements, involuntary multifocal myoclonus, and cerebellar ataxia. Although several paraneoplastic antibodies against postsynaptic or cell-surface antigens have been reported, usually most patients are serum antibody negative. We report a 65-year-old patient with opsoclonus-myoclonus syndrome revealing a small-cell lung carcinoma. If serologic antineuronal anti-body screening was negative, autoantibodies against glutamic acid decarboxylase (anti-GAD) were positive. Despite the specific anticancer treatment and high dose corticosteroids, the patient developed a severe and progressive encephalopathy and died 10 days later. 1. Introduction Opsoclonus-myoclonus syndrome (OMS) is characterized by rapid, involuntary multivectorial eye movements without intersaccadic intervals. It is associated with involuntary multifocal myoclonus mainly affecting the trunk, limbs, and head. Cerebellar ataxia and uncoordinated voluntary movements may also be seen. Pathophysiologically OMS appears to be an immune-mediated disease where positive titres directed at anti-neuronal antibodies in the serum and cerebrospinal fluid (CSF) are occasionally detected. OMS has been linked to infections and metabolic disorders and has been documented as a paraneoplastic syndrome. The paraneoplastic opsoclonus-myoclonus syndrome, also called “dancing eyes syndrome,” is a rare entity among the paraneoplastic neurologic disorders (PND) [1]. OMS is mainly associated with neuroblastoma in children; however, it has also been reported in patients with small-cell lung cancer (SCLC) and breast and ovarian malignancies. In addition, there have been case reports in the literature which have associated OMS with non-small-cell lung cancer, melanoma, sarcoma, and non-Hodgkin’s lymphoma [2–5]. In this paper, we report the case of a male patient with pathologically proven small-cell lung cancer who presented with symptoms compatible with OMS. This was the first clinical manifestation of an underlying malignancy. He demonstrated a rapid deterioration in his clinical state leading to death despite the introduction of chemotherapy active against the small-cell lung cancer. 2. Case Report A 65-year-old man presented to the emergency department of our institution with a history of left hemithoracic pain, weight loss, gait ataxia, and tremor. He had a 120-pack-year smoking history and known ischemic cardiomyopathy with previous coronary stenting. On
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