Myoclonus, ataxia and dancing eyes – visual diagnosis with diverse phenotype. Two cases of Opsoclonus-Myoclonus-Syndrome after adenoviral infection and scarlet fever

Etiology of movement disorders in childhood is diverse, often diagnosis remains descriptive and therapy symptomatic. Autoimmune and paraneoplastic etiology is rare in childhood.

We present 2 patients, who show characteristic findings of motor function und psyche in Opsoclonus-Myoclonus-Syndrome (OMS) as typical diversity of disease severity.

Our cases illustrate long term course of disease, common misdiagnoses, failing therapies and latency of diagnosis in absence of knowledge and in knowledge of this specific clinical disease. We present typical labaratory findings and show the presence of autoimmune processes directed mainly against cerebellar cells by means of immunohistochemistry, as well as different therapeutical regiments. We expand the spectrum of non-paraneoplastic etiology by adding adenoviral and A-streptococcal infections as associated factors.