Opsoclonus-myoclonus syndrome (OMS) is a neurological and inflammatory condition. In many cases, the condition is paraneoplastic in origin, meaning it occurs after the immune system attacks healthy tissue alongside cancer cells. The disease typically has an abrupt and severe onset and may cause chronic symptoms. The typical treatment lasts for one to two years and involves intense immunotherapy, the overall goal of which is to cause complete remission. In paraneoplastic cases, patients often seek treatment for opsoclonus-myoclonus syndrome symptoms before discovering the underlying cancer.
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Strabismus occurs when the eyes don't align properly and fail to work together. With strabismus, one eye can focus on objects, but the other is aligned inward, upward, outward, or downward. The condition might be intermittent or constant. To stop double vision from happening, the brain usually ignores whatever input the misaligned eye gives. This causes 'lazy eye.' It's estimated about four percent of individuals in the United States have some form of strabismus. Each eye is controlled by six external muscles. For an individual to have normal vision with both eyes, the functioning and neurological control of all the muscles must coordinate seamlessly. When anatomical or neurological problems keep the eye muscles from functioning properly, the eyes become misaligned, leading to strabismus. In opsoclonus-myoclonus syndrome, the cause is neurological. When the condition isn't related to opsoclonus-myoclonus syndrome, it might be caused by muscle problems.
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Issues With Sleep
It's common for parents of children with opsoclonus-myoclonus syndrome to observe issues with sleep. These may be coupled with rage attacks. One study indicates the two symptoms might be related to monoaminergic dysfunction. Monoaminergic actions are related to monoamine neurotransmitters, which include histamine, epinephrine, norepinephrine, dopamine, and serotonin. Improper regulation of these neurotransmitters can lead to disturbed sleep and serious mood disorders.
There are a number of different sleep issues observed in opsoclonus-myoclonus syndrome patients. They may have fragmented sleep, reduced sleep quality, non-restorative sleep, and sleep latency. They may also snore. In a study of thirty-two opsoclonus-myoclonus syndrome patients with sleep issues, twenty-five also experienced common rage attacks. The children who slept less than ten hours a night also had more rage attacks than children who got more sleep. When these children were treated with trazodone, both behavior and sleep were improved in ninety-five percent of the patients. The number of awakenings decreased by seventy-six percent, and the total amount of sleep time increased by seventy-two percent.
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Acute Cerebellar Ataxia
Acute cerebellar ataxia is a neurological disorder that occurs when the cerebellum is damaged or inflamed. The cerebellum controls muscle coordination and a person's gait. Ataxia occurs when individuals lose the ability to coordinate or control their voluntary muscle movements. In acute cases, ataxia happens quickly, generally showing up within a few minutes to two days. Acute cerebellar ataxia causes a loss of coordination that makes it difficult to perform day-to-day tasks. The condition is most commonly seen in children from two to seven years old. Most opsoclonus-myoclonus syndrome patients are also children. There are multiple symptoms of acute cerebellar ataxia, including impaired coordination in the legs, arms, or torso, along with an unsteady gait and frequent stumbling. Patients may have trouble with eating, writing, buttoning shirts, and other tasks requiring fine motor skills. Slurred speech and vocal changes are also common, and some patients may experience dizziness and headaches.
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Opsoclonus, one of the core symptoms of opsoclonus-myoclonus syndrome, is a condition that causes uncontrolled eye movements. The eye movements are repeated, rapid, and random. They may involve movements in diagonal, vertical, and horizontal directions. There's also a vision condition called nystagmus, in which an individual's eyes make uncontrolled and repetitive movements. The movements can reduce a patient's vision and decrease their depth perception. In addition, coordination and balance may be affected due to the involuntary visual input. When this is combined with ataxia, it leads to serious trouble functioning in day-to-day life. Nystagmus tends to be a sign there's another underlying medical issue. Sometimes contact lenses and eyeglasses can improve a patient's vision, but they won't cure nystagmus.
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Aphasia is a language impairment that affects an individual's ability to produce or comprehend speech. It can also affect their ability to write and read. The condition is always related to a brain injury. In the case of opsoclonus-myoclonus syndrome patients, aphasia is caused by brain inflammation. Some patients may have trouble articulating speech, a condition called dysarthria. There have been cases where patients completely lost their ability to speak or use language. Aphasia presents in a number of different ways, and the symptoms vary in severity. Patients may have trouble comprehending language, reading, or writing. They might not be able to follow instructions and may speak gibberish. It's common for patients to enunciate poorly, struggle to name objects, struggle to form words, and be unable to speak spontaneously. Patients also may not be able to repeat phrases, or they might persistently repeat one syllable or phrase.