title: A Toddler With Uncontrollable Shaking After a Minor Fall.
abstract: A toddler with a closed head injury six days prior to admission, recently diagnosed with post-concussive syndrome and acute otitis media presented to our emergency department with complaint of uncontrollable shaking of the head and extremities. Physical examination demonstrated dancing movements of the eyes and truncal ataxia, concerning for the diagnosis of opsoclonus-myoclonus syndrome. Magnetic resonance imaging study was consistent with a retroperitoneal mass that was confirmed as neuroblastoma by metaiodobenzylguanidine scan and later surgical resection. We present this case, accompanied by a video of the patient, to help the emergency physician recognize this rare and often misdiagnosed syndrome.
authors.affiliation: From the *Department of Pediatrics, Pediatric Residency Program, and †Division of Emergency Medicine, Department of Pediatrics, Children's Hospital Los Angeles, Keck School of Medicine at the University of Southern California, Los Angeles, CA.
authors.forename: Henry
authors.initials: H
authors.lastname: Wu
authors.forename: Ameer P
authors.initials: AP
authors.lastname: Mody
mesh_terms: D000058:Accidental Falls; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D007813:Laparotomy; D008279:Magnetic Resonance Imaging; D009447:Neuroblastoma / Q000175:diagnosis* / Q000601:surgery; D053578:Opsoclonus-Myoclonus Syndrome / Q000175:diagnosis / Q000209:etiology*; D038223:Post-Concussion Syndrome / Q000175:diagnosis; D012186:Retroperitoneal Neoplasms / Q000175:diagnosis* / Q000601:surgery