Opsoclonus refers to uncontrolled, irregular, and nonrhythmic
eye movement
Eye movement includes the voluntary or involuntary movement of the eyes. Eye movements are used by a number of organisms (e.g. primates, rodents, flies, birds, fish, cats, crabs, octopus) to fixate, inspect and track visual objects of inte ...
. Opsoclonus consists of rapid, involuntary, multivectorial (horizontal and vertical), unpredictable,
conjugate fast eye movements without inter-
saccadic
In vision science, a saccade ( ; ; ) is a quick, simultaneous movement of both eyes between two or more phases of focal points in the same direction. In contrast, in smooth-pursuit movements, the eyes move smoothly instead of in jumps. Control ...
intervals.
It is also referred to as saccadomania or reflexive
saccade
In vision science, a saccade ( ; ; ) is a quick, simultaneous movement of both Eye movement (sensory), eyes between two or more phases of focal points in the same direction. In contrast, in Smooth pursuit, smooth-pursuit movements, the eyes mov ...
. The movements of opsoclonus may have a very small
amplitude
The amplitude of a periodic variable is a measure of its change in a single period (such as time or spatial period). The amplitude of a non-periodic signal is its magnitude compared with a reference value. There are various definitions of am ...
, appearing as tiny deviations from primary position.
Possible causes of opsoclonus include
neuroblastoma
Neuroblastoma (NB) is a type of cancer that forms in certain types of nerve tissue. It most frequently starts from one of the adrenal glands but can also develop in the head, neck, chest, abdomen, or Vertebral column, spine. Symptoms may include ...
and
encephalitis
Encephalitis is inflammation of the Human brain, brain. The severity can be variable with symptoms including reduction or alteration in consciousness, aphasia, headache, fever, confusion, a stiff neck, and vomiting. Complications may include se ...
in children, and breast, lung, or ovarian cancer in adults. Other considerations include
GLUT1 Deficiency Syndrome
GLUT1 deficiency syndrome, also known as GLUT1-DS, De Vivo disease or Glucose transporter type 1 deficiency syndrome, is an autosomal dominant genetic metabolic disorder associated with a deficiency of GLUT1, the protein that transports glucose a ...
,
multiple sclerosis
Multiple sclerosis (MS) is an autoimmune disease resulting in damage to myelinthe insulating covers of nerve cellsin the brain and spinal cord. As a demyelinating disease, MS disrupts the nervous system's ability to Action potential, transmit ...
, toxins, medication effects (e.g.
Serotonin Syndrome
Serotonin syndrome (SS) is a group of symptoms that may occur with the use of certain Serotonin, serotonergic medications or Recreational drug use, drugs. The symptoms can range from mild to severe, and are potentially fatal. Symptoms in mild c ...
),
celiac disease
Coeliac disease (British English) or celiac disease (American English) is a long-term autoimmune disorder, primarily affecting the small intestine. Patients develop intolerance to gluten, which is present in foods such as wheat, rye, spel ...
, certain infections (
West Nile virus
West Nile virus (WNV) is a single-stranded RNA virus that causes West Nile fever. It is a member of the family ''Flaviviridae'', from the genus ''Flavivirus'', which also contains the Zika virus, dengue virus, and yellow fever virus. The virus ...
,
Lyme disease
Lyme disease, also known as Lyme borreliosis, is a tick-borne disease caused by species of ''Borrelia'' bacteria, Disease vector, transmitted by blood-feeding ticks in the genus ''Ixodes''. It is the most common disease spread by ticks in th ...
),
non-Hodgkin lymphoma
Non-Hodgkin lymphoma (NHL), also known as non-Hodgkin's lymphoma, is a group of blood cancers that includes all types of lymphomas except Hodgkin lymphomas. Symptoms include enlarged lymph nodes, fever, night sweats, weight loss, and tiredn ...
, and renal
adenocarcinoma
Adenocarcinoma (; plural adenocarcinomas or adenocarcinomata ; AC) is a type of cancerous tumor that can occur in several parts of the body. It is defined as neoplasia of epithelial tissue that has glandular origin, glandular characteristics, or ...
.
[ ] It can also be caused by a lesion in the omnipause neurons which tonically inhibit initiation of saccadic eye movement (until signaled by the
superior colliculus
In neuroanatomy, the superior colliculus () is a structure lying on the tectum, roof of the mammalian midbrain. In non-mammalian vertebrates, the Homology (biology), homologous structure is known as the optic tectum or optic lobe. The adjective f ...
) by blocking
paramedian pontine reticular formation
The paramedian pontine reticular formation (PPRF) is a subset of neurons of the oral and caudal pontine reticular nuclei. With the abducens nucleus it makes up the horizontal gaze centre. It is situated in the pons adjacent to the abducens nu ...
(PPRF) burst neurons in the
pons
The pons (from Latin , "bridge") is part of the brainstem that in humans and other mammals, lies inferior to the midbrain, superior to the medulla oblongata and anterior to the cerebellum.
The pons is also called the pons Varolii ("bridge of ...
. It frequently occurs along with
myoclonus
Myoclonus is a brief, involuntary, irregular (lacking rhythm) twitching of a muscle, a joint, or a group of muscles, different from clonus, which is rhythmic or regular. Myoclonus ( myo- "muscle", clonus "spasm") describes a medical sign and, ...
in
opsoclonus myoclonus syndrome.
See also
*
Clonus
Clonus is a set of involuntary and rhythmic muscular contractions and relaxations. Clonus is a sign of certain neurological conditions, particularly associated with upper motor neuron lesions involving descending motor pathways, and in many cas ...
*
Migraine
Migraine (, ) is a complex neurological disorder characterized by episodes of moderate-to-severe headache, most often unilateral and generally associated with nausea, and light and sound sensitivity. Other characterizing symptoms may includ ...
*
Epilepsy
Epilepsy is a group of Non-communicable disease, non-communicable Neurological disorder, neurological disorders characterized by a tendency for recurrent, unprovoked Seizure, seizures. A seizure is a sudden burst of abnormal electrical activit ...
*
Pathologic nystagmus
Nystagmus is a condition of involuntary (or voluntary, in some cases) eye movement. People can be born with it but more commonly acquire it in infancy or later in life. In many cases it may result in reduced or limited vision.
In normal eyesig ...
*
Physiologic nystagmus
*
Psychogenic non-epileptic seizures
Psychogenic non-epileptic seizures (PNES), also referred to as functional seizures or dissociative seizures, are episodes that resemble epileptic seizures but are not caused by abnormal electrical activity in the brain. Instead, they are classi ...
*
Ocular flutter
References
External links
Opsoclonus in cancer
Medical signs
{{eye-stub