Figure 1
Neuronal structures and pathways implicated in physiologic saccadic eye movements, putatively implicated in the pathophysiology of opsoclonus. PC: purkinje cells; FN: fastigial nucleus; ON: omnipause neurons; PPRF: parapontine reticular formation; riMLF: rostral interstitial nucleus of the medial longitudinal fasciculus.
Figure 2
Algorithm of articles inclusion/exclusion.
Video 1
Opsoclonus happening during an outpatient visit when the patient was on 200 mg of amantadine.
Table 1
List of toxic/drugs causing opsoclonus classified by number of cases (n = ) and in the order of appearance in the article.
| DRUG/TOXIC | PUTATIVE IMPLICATED SYSTEM | REFERENCE | NUMBER OF CASES (PER MECHANISM OF ACTION) | n | NARANJO SCORE |
|---|---|---|---|---|---|
| bark scorpion poison (c. sculpturatus) | sodium channel inactivation, increased release of norepinephrine and acetylcholine | [15] | n = 117 | n = 84 | 6 |
| [16] | n = 33 | 7 | |||
| chlordecone (or kepone, merex, curlone) | mitochondrial Na+/K+ ATPase inhibition | [17] | n = 15 | n = 15 | 5 |
| [18] | 6 | ||||
| [19, 20] | 6 | ||||
| diphenhydramine (DPH) | anticholinergic & antihistaminic H1 | [23] | n = 3 | n = 1 | 4 |
| [24] | n = 1 | 7 | |||
| [25] | n = 1 | 5 | |||
| chlorpyrifos (organophosphate) | cholinergic | [26] | n = 3 | n = 1 | 6 |
| malathion (organophosphate) | [27] | n = 1 | 7 | ||
| parathion and methyl-parathion (organophosphates) | [28] | n = 1 | 6 | ||
| lamotrigine (associated with valproate – probably not implicated) | various mechanisms: voltage-gated sodium channel blocker or GABAergic | [32] | n = 3 | n = 1 | 6 |
| phenytoin associated and diazepam, versus barbiturate withdrawal | [33] | n = 1 | 6 | ||
| phenytoin (associated with levetiracetam – probably not implicated) | [34] | n = 1 | 5 | ||
| cocaine | serotoninergic & dopaminergic & noradrenergic (reuptake blockage) | [36] | n = 2 | n = 1 | 7 |
| [37] | n = 1 | 7 | |||
| cyclosporine A | dopaminergic | [7] | n = 2 | n = 1 | 5 |
| [38] | n = 1 | 6 | |||
| toluene (methylbenzene) | GABAergic, glutamatergic, and cholinergic | [41] | n = 2 | n = 1 | 5 |
| [42] | n = 1 | 6 | |||
| lithium associated with haloperidol | glycinergic & dopaminergic | [45] | n = 2 | n = 2 | 4 |
| amantadine (our case report) | glutamatergic | n = 1 | n = 1 | 7 | |
| phencyclidine (PCP) | glutamatergic & GABAergic | [9] | n = 1 | n = 1 | 6 |
| solanum torvum berries (or turkey berries, susumber, aubergine sauvage) | cholinergic | [49] | n = 1 | n = 1 | 6 |
| thallium | potassium interference (Na+/K+-ATPase) | [52] | n = 1 | n = 1 | 6 |
| cefepime | GABAergic | [54] | n = 1 | n = 1 | 6 |
| adenovector viral (AVV) ChAdOx1 vaccine (AZD1222) (AstraZeneca) | unclear | [63] | n = 1 | n = 1 | 3 |
| carbon monoxide | unclear | [64] | n = 1 | n = 1 | 4 |
| amitriptyline | cholinergic & serotoninergic | [65] | n = 1 | n = 1 | 5 |
| venlafaxine | serotoninergic & noradrenergic | [66] | n = 1 | n = 1 | 2 |
[i] In bold: discussed in the article.