Adult-onset opsoclonus-myoclonus which is rare, striking and always demands a thorough workup. This chaotic eye movement and body jerking combination can be the tip of a neurologic iceberg. The differential diagnosis includes paraneoplastic syndromes and think about lung, breast, ovarian cancers and don't forget anti-Ri or anti-Hu antibodies. Always think about neuroblastoma. Also keep in mind autoimmune encephalitis (NMDA receptor, GAD65), post-infectious causes (especially West Nile or Epstein
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