Paraneoplastic vertigo

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

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