Neuro-ophthalmology and pupils: opsoclonus in children: practice question

A Ophthalmology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Ophthalmology · Neuro-ophthalmology and pupils: opsoclonus in children

Sample item

A 18-month-old child has chaotic, conjugate, multidirectional eye jerks, jerky limb movements and irritability. Which underlying condition must be excluded?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Neuroblastoma

Opsoclonus-myoclonus in a young child is a paraneoplastic syndrome most often associated with neuroblastoma. Imaging of the chest and abdomen and urinary catecholamines are required. The neurological syndrome may persist after tumour removal.

Option by option

  • A. Neuroblastoma (correct)

    Correct. Opsoclonus-myoclonus is a classic paraneoplastic sign of neuroblastoma.

  • B. Medulloepithelioma

    Medulloepithelioma is an intraocular tumour of the ciliary body.

  • C. Retinoblastoma

    Retinoblastoma presents with leukocoria or squint, not opsoclonus.

  • D. Wilms tumour

    Wilms tumour presents with an abdominal mass and is not linked with opsoclonus.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Ophthalmology question

What is the answer to this Ophthalmology question?

The best answer is A, Neuroblastoma. Opsoclonus-myoclonus in a young child is a paraneoplastic syndrome most often associated with neuroblastoma.

Why is "Medulloepithelioma" not the answer?

Medulloepithelioma is an intraocular tumour of the ciliary body.

Why is "Retinoblastoma" not the answer?

Retinoblastoma presents with leukocoria or squint, not opsoclonus.

Why is "Wilms tumour" not the answer?

Wilms tumour presents with an abdominal mass and is not linked with opsoclonus.

What concept does this question test?

It tests Neuro-ophthalmology and pupils: opsoclonus in children in Ophthalmology. Imaging of the chest and abdomen and urinary catecholamines are required. The neurological syndrome may persist after tumour removal.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neuro-ophthalmology and pupils: opsoclonus in children?

Group the red eye by what to examine and what the pupil does. Then use the flashcards and the other Ophthalmology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.