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