We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Correspondence |

Anxiety as Initial Diagnosis in Opsoclonus Myoclonus Syndrome—Reply

Mary Kurian, MD; Patrice H. Lalive, MD; Judit Horvath, MD
Arch Neurol. 2010;67(9):1155. doi:10.1001/archneurol.2010.193.
Text Size: A A A
Published online


In reply

Korn-Lubetzki et al have described the case of a young woman who presented with OMS preceded by psychiatric symptoms diagnosed as severe anxiety. Findings of oncologic evaluation were negative, the cerebrospinal fluid protein level was elevated, and antistreptolysin O titer was high; however, the authors have not mentioned whether anti-NMDAR or any other antibodies related to OMS have been identified in the serum/cerebrospinal fluid of their patient. The clinical course is also different from that of our patient, who presented with symptoms of depression and psychomotor slowing, gait instability, and OMS followed by the typical phases of anti–NMDA receptor encephalitis (akinetic, hyperkinetic, and then slow recovery). Their patient also had a dramatic improvement with intravenous immunoglobulin therapy. Despite differences in the possible etiology, the case described by the authors illustrates well the importance of recognizing OMS in possible paraneoplastic, postinfectious, or autoimmune etiologies. In most cases, this justifies early treatment with intravenous immunoglobulin.1

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles

Care at the Close of Life: Evidence and Experience