Opsoclonus is an involuntary eye movement disorder in which there are chaotic, usually conjugate, multidimensional saccadic eye movements. In this paper 2 cases of opsoclonus are reported, as a paraneoplastic phenomenon in association with oat cell carcinoma of the lung. It has previously been hypothesized that opsoclonus results from dysfunction of a group of premotor neurons in the brainstem called omnipause neurons. We describe the location of these cells in man by homology with animal studies, and describe the light microscopic appearance of these neurons in the 2 cases of opsoclonus. Although these neurons appeared normal it is still possible that their function was disturbed as a result of metabolic or neurotransmitter abnormalities.
SUMMARY
The absorption of radioactive vitamin B12 (cyanocobalamin) has been studied by the Schilling procedure in 27 patients with anaemia after Polya partial gastrectomy and in 10 patients with Addisonian pernicious anaemia.
In patients who have had Polya partial gastrectomy absorption of vitamin B12 was often increased when the dose was given with a meal containing only a small quantity of the vitamin, and when the dose was given after an injection of histamine.
In the patients with pernicious anaemia histamine did not enhance absorption of vitamin B12, and food did not alter the absorption of the vitamin when given with a small quantity of intrinsic factor.
Improved absorption of vitamin B12 with food or after histamine is likely to be due to stimulation of a small residual secretion of intrinsic factor.
The results of the standard fasting Schilling test appeared to correlate better with the development of deficiency of vitamin B12 than tests with food or after histamine.
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