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Journal of Case Reports
Rare Paraneoplastic Opsoclonus Myoclonus Syndrome (POMS) in a Recurrent Breast Cancer Patient: Importance of Early Recognition of POMS and Initiation of Rehabilitation Intervention

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Saw Hay Mar, Tan Pei Ling, Tan YeowLeng
Department of Rehabilitation Medicine, Singapore General Hospital, Singapore Health Services, Outram Road, Singapore.
Corresponding Author:
Dr. Saw Hay Mar
Email: saw.hay.mar@singhealth.com.sg
Received: 02-FEB-2017 Accepted: 17-MAR-2017 Published Online: 30-MAR-2017
DOI: http://dx.doi.org/10.17659/01.2017.0033
Abstract
Background: Opsoclonus myoclonus syndrome is a rare condition characterized by the amalgamation of multidirectional saccades of eye movements, involuntary myoclonus predominantly affecting trunk and limbs and cerebellar ataxia. Typical malignancies associated with paraneoplatic opsoclonus myoclonus syndrome (POMS) in adults are small cell lung carcinoma and breast cancer with variable outcomes. Case Report: The authors report here a patient with stage IV recurrent right breast cancer, presenting to the hospital with unsteady gait, jerky movements of the limbs and body. She was clinically diagnosed with POMS with positive cerebrospinal fluid anti-Ri antibody. Medical treatment with intravenous methylprednisolone and early initiation of rehabilitation improved her balance, coordination and ataxia. This led to an overall improvement in her physical function. Conclusion: This case illustrates the importance of early recognition, prompt treatment of POMS and initiation of rehabilitation in achieving better functional outcomes.
Keywords : Ataxia, Breast Neoplasms, Gait Disorders, Opsoclonus-Myoclonus Syndrome, Small Cell Lung Carcinoma.
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