However, the OMS gradually improved after spontaneous miscarriage in one case. Whether the symptoms improved because the pregnancy ended or because of corticosteroid therapy remains unclear. In all three cases the OMS occurred in the middle to late stages of pregnancy. The condition of the fetuses were good, except in the one case that miscarried. Complication of pregnancy In three reported cases from Japan of the opsoclonus-myoclonus syndrome (OMS) during pregnancy, the neurologic symptoms were entirely similar to those of OMS unrelated to pregnancy with opsoclonus/flutter, trunkal ataxia and myoclonic jerks of the neck and limbs. Toxins: chlordecone, thallium, strychnine, toluene, and organophosphates or 5. Side effects of drugs: lithium, amitriptyline, cocaine and phenytoin with diazepam. Paraneoplastic opsoclonus/flutter due to an occult neoplasm 2. When the amplitude is very small, the oscillation can only be detected with an ophthalmoscope or on eye movement recordings, and then the term microflutter is used to describe the disorder.Ocular flutter is intermittent and mainly associated with voluntary saccades - flutter dysmetria.The frequency of oscillations is usually high, typically 10 to 25 cycles per second, as evident in this case.Horizontal saccadic oscillations without an intersaccadic interval.
This patient with MS has ocular flutter characterized by: post enteroviral infection, cerebral malaria, cyclosporine treatment and meningitis, but perhaps most frequently associated with parainfectious states or, with opsoclonus, as a paraneoplastic manifestation of occult malignancy. Since then, there have been over 50 reports, usually single cases or small series, linking the phenomenon to a wide variety of brainstem and cerebellar conditions, e.g. In 1954 Cogan first used the term "ocular flutter" to describe a rare disorder of horizontal eye movements characterized by rapid bursts of synchronous back-to-back horizontal oscillatory movements usually seen in the primary position of gaze. The patient was seen prior to the availability of neuroimaging by MRI. Neuro-ophthalmological examination: The examination was normal apart from the eye movements which showed, in central gaze, episodic bursts of horizontal back-to-back saccades without an intersaccadic interval characteristic of ocular flutter. She was given a diagnosis of multiple sclerosis (MS). Six months later, she became unsteady walking and was found to have bilateral ataxia. This patient was seen in the Neurovisual Clinic for evaluation of a monocular attack of optic neuritis which completely resolved. Ocular Flutter Multiple Sclerosis Lid Flutter Multiple Sclerosis Ocular Flutter
Wray, MD, PhD, FRCP, Professor of Neurology, Harvard Medical School Director, Unit for Neurovisual Disorders, Massachusetts General Hospital Wray, M.D., Ph.D., FRCP, Professor of Neurology Harvard Medical School, Director, Unit for Neurovisual Disorders, Massachusetts General Hospital
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