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Teaching Video NeuroImages: Maneuvers to elicit opsoclonus in opsoclonus-myoclonus syndrome

A 34-year-old woman presented with vertigo, jerky movements, and imbalance over 2 weeks. Examination demonstrated multiplanar back-to-back saccadic oscillations without an intersaccadic interval (video 1 at Neurology.org), myoclonus, and ataxia (video 2). MRI of the brain and malignancy screen were unremarkable. Positive serum onconeuronal antibodies (anti-Yo and anti-Ri) supported the diagnosis of paraneoplastic opsoclonus-myoclonus syndrome.