The most successful option is steroids. ACTH trials in adults have not been reported. Unfortunately, not all patients respond to steroids. Tumor removal, when appropriate, has a variable effect on opsoclonus. In the parainfectious setting, the prognosis for patients with opsoclonus depends on the age at onset.
Most adults undergo a benign course.
The childhood form unfortunately often results in residual neurologic deficits. In the paraneoplastic setting, age is one of several prognostic factors. In adults, the tumor is variable and the prognosis is grim. In children, the tumors are usually neural crest derived and the prognosis is good, if the diagnosis is made early. Musarella et al found that the prognosis was better if opsoclonus was diagnosed before age of 2.