めまいで発症した傍腫瘍性オプソクローヌス・ミオクローヌス症候群

Abstract

A case of paraneoplastic opsoclonus-myoclonus syndrome with an onset of vertigo is reported. A 72-year-old man complaining of vertigo, nausea and vomiting consulted our hospital on March 13, 2006. Since neurological examination showed opsoclonus of the eye movement, ataxia and adiadochokinesis, disequilibrium due to a central nervous system disorder was strongly suggested. Brain MRI did not demonstrate any evidence of tumor or ischemic lesion. CSF analysis did not show any malignant cells. However, lung X-ray image showed an abnormal shadow in the upper lung field. Therefore, a biopsy was performed under bronchoscopy and small cell lung carcinoma was diagnosed. Based on these findings, the patient was diagnosised as having paraneoplastic opsoclonus-myoclonus syndrome from small cell lung carcinoma. Anti-Ri and anti-Hu antibodies were unremarkable. He was treated with antidinic, psychomimetic and antineoplastic therapies. Vertiginous sensation and nausea decreased but opsoclonus persisted. He died of pneumonia on June 30th, 2006.