Opsoclonus in Pediatric Patients: Differential Diagnosis and a Practical Approach to Evaluation

ABSTRACT Opsoclonus is an ocular dyskinesia characterized by involuntary, arrhythmic, multidirectional saccades. In pediatrics, opsoclonus is most commonly attributed to the rare neuroinflammatory disorder opsoclonus‐myoclonus‐ataxia syndrome (OMAS), typically considered a paraneoplastic syndrome associated with neural crest tumors. However, opsoclonus can manifest as a symptom of other disease processes including toxic, metabolic, and genetic etiologies, and there is a paucity of literature focusing on the differential diagnoses and etiologic workup of opsoclonus in children. This review aims to address this knowledge gap with the ultimate goal of providing a schema facilitating the evaluation of a pediatric patient presenting with opsoclonus.