Today’s noon conference was about a patient with history of smoking presenting with 3 month history of dizziness, nystagmus and myoclonic jerks. On exam they had opsoclonus and rotational nystagmus – consistent with opsoclonus myoclonus syndrome. A rare paraneoplastic syndrome found in some cases of SCLC. We also discussed approached to dizziness and nystagmus. More information here paraneoplastic vertigo – 11.22 and here nejmra023009
Take home points:
Dizziness is a very common complaint with a broad differential (of which vertigo is just one category)
The majority of cases of dizziness can be diagnosed by history alone
The HINTS exam can be used to identify cases of central vertigo
Paraneoplastic syndromes are highly associated with lung cancer but can present with other malignancies
Specific types of cancers are associated with specific PNS