1 Ocular flutter has been considered to be a subform of opsoclonus, probably caused by a loss of tonic stimulation of omnipause neurons. Ocular flutter is a rare oculomotor syndrome that is clinically defined by intermittent bursts of involuntary conjugate eye oscillations with a strict preponderance for the horizontal plane and without intersaccadic interval. The association with ganglioside antibodies lends further support to the notion of an autoimmune-associated pathology of the syndrome. Positive titers of IgG and IgM anti-GQ1b antibodies were found.Ĭonclusions This is the first description of an association between the clinical syndrome of ocular flutter, mild stimulus sensitive myoclonus, and trunk ataxia and anti-GQ1b antibodies. Results of screening examinations for neoplasms and paraneoplastic antibodies, including whole-body fludeoxyglucose F18 positron emission tomography, were normal. Results of extensive serological tests on viral, bacterial, and fungal infections from blood and cerebrospinal fluid samples were unremarkable. Cerebrospinal fluid examination revealed mild lymphocytic pleocytosis. Results Brain magnetic resonance imaging results were normal.
Patient A 37-year-old woman presented with rapid, conjugated, and periodic oscillations of the eyes with a strict preponderance for the horizontal plane (ocular flutter) trunk ataxia and occasional arrhythmic muscle jerks (myoclonus) most pronounced at the neck. Objective To describe a movement disorder characterized by ocular flutter, trunk ataxia, and mild generalized myoclonus associated with anti-GQ1b antibodies. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.
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