Aquilina Annelise, Dingli Nicola, Aquilina Josanne
Department of Neurosciences, Mater Dei Hospital, Attard, Malta.
Department of Neuroscience, Mater Dei Hospital, Msida, Malta.
BMJ Case Rep. 2017 Apr 21;2017:bcr-2017-219859. doi: 10.1136/bcr-2017-219859.
Opsoclonus myoclonus syndrome (OMS) is a rare, neurological condition affecting 1 in 10 000 000 people annually. Opsoclonus, defined as involuntary rapid, multivectorial oscillations of the eyes, together with ataxia and myoclonus are usually present. OMS may be paraneoplastic: often associated with occult neuroblastoma in childhood and with breast carcinoma or small cell lung carcinoma in adults. Other aetiologies include viral or toxic agents. The pathogenesis is thought to be immune mediated. A 37-year-old woman with previous inflammatory cranial mononeuropathies was admitted for elective dilatation and curettage (D&C). Immediately after she complained of left-sided paraesthesia and later became disoriented, with incoherent speech, inability to obey commands, opsoclonus of the eyes and myoclonic jerks. Investigations including onconeuronal antibodies, cerebrospinal fluid analysis, and imaging were normal. She was treated with intravenous methylprednisolone with rapid improvement. Previous surgeries with anaesthesia were uncomplicated. The anaesthetic agents used for the D&C were fentanyl and propofol.
眼阵挛-肌阵挛综合征（OMS）是一种罕见的神经系统疾病，每年影响着千万分之一的人群。眼阵挛被定义为眼球不自主的快速、多向量摆动，通常伴有共济失调和肌阵挛。OMS可能是副肿瘤性的：在儿童中常与隐匿性神经母细胞瘤相关，在成人中与乳腺癌或小细胞肺癌相关。其他病因包括病毒或毒性因子。其发病机制被认为是免疫介导的。一名37岁曾患炎性颅单神经病的女性因择期刮宫术（D&C）入院。术后她立即抱怨左侧感觉异常，随后出现定向障碍、言语不连贯、无法听从指令、眼球眼阵挛和肌阵挛性抽搐。包括肿瘤神经元抗体、脑脊液分析和影像学检查在内的各项检查均正常。她接受了静脉注射甲泼尼龙治疗，病情迅速好转。既往的麻醉手术均无并发症。此次刮宫术使用的麻醉药物为芬太尼和丙泊酚。
