Opsoclonus, Occult Carcinoma, and Chemical Pathology in Dentate Nuclei

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Abstract
OPSOCLONUS is a term introduced by Orzechowski1 in 1913 to denote an irregular, continual, chaotic agitation of the eyes. It differs from nystagmus in not being rhythmic; it differs from ocular dysmetria and flutter2 and from lightning eye movements3 in being more sustained, totally irregular, and occurring in various planes. Myoclonic jerks often are present in the face, neck, trunk, and extremities. In their recent review Smith and Walsh4 discussed 14 previously reported cases and added two of their own. Most authors have attributed opsoclonus to a presumed encephalitis and found it to carry a good prognosis. However, two of Cogan's2 patients died; autoposy of one revealed encephalitis involving chiefly the hypothalamus, midbrain, and pons. While the precise sites of lesions producing myoclonus are conjectural, evidence indicates irritation or incomplete destruction of dentatothal-amocortical connections.5 This paper concerns a patient with occult bronchogenic carcinoma

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