{"id":12388,"date":"2024-10-11T22:21:27","date_gmt":"2024-10-11T20:21:27","guid":{"rendered":"https:\/\/valintermed.com\/?p=12388"},"modified":"2024-10-11T22:21:27","modified_gmt":"2024-10-11T20:21:27","slug":"sindrom-opsoklonusa-mioklonusa","status":"publish","type":"post","link":"https:\/\/valintermed.com\/en\/medlibrary\/syndrome-opsoklonusa-mioklonusa\/","title":{"rendered":"Opsoclonus-myoclonus syndrome"},"content":{"rendered":"<div class=\"fpm_start\"><\/div>\n<p>Opsoclonus-myoclonus syndrome (OMS) is a rare neurological disorder characterized by paroxysmal attacks of myoclonus (sudden, brief muscle contractions) and opsoclonus (uncontrolled eye movements). The disorder is often associated with certain types of tumors, particularly in children, such as neuroblastoma. The syndrome may present with a variety of neurological symptoms, including ataxia, tremor, and mental status changes. These manifestations may significantly impair the quality of life of patients and require a comprehensive approach to diagnosis and treatment. Despite its rarity, opsoclonus-myoclonus syndrome represents an important problem in clinical practice.<\/p>\n<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_85 counter-flat ez-toc-counter ez-toc-light-blue ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Content<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewbox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewbox=\"0 0 24 24\" version=\"1.2\" baseprofile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 eztoc-toggle-hide-by-default' ><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/syndrome-opsoklonusa-mioklonusa\/#%D0%98%D1%81%D1%82%D0%BE%D1%80%D0%B8%D1%8F_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F_%D0%B8_%D0%B8%D0%BD%D1%82%D0%B5%D1%80%D0%B5%D1%81%D0%BD%D1%8B%D0%B5_%D0%B8%D1%81%D1%82%D0%BE%D1%80%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B8%D0%B5_%D1%84%D0%B0%D0%BA%D1%82%D1%8B\" >History of the disease and interesting historical facts<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/syndrome-opsoklonusa-mioklonusa\/#%D0%AD%D0%BF%D0%B8%D0%B4%D0%B5%D0%BC%D0%B8%D0%BE%D0%BB%D0%BE%D0%B3%D0%B8%D1%8F\" >Epidemiology<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/syndrome-opsoklonusa-mioklonusa\/#%D0%93%D0%B5%D0%BD%D0%B5%D1%82%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B0%D1%8F_%D0%BF%D1%80%D0%B5%D0%B4%D1%80%D0%B0%D1%81%D0%BF%D0%BE%D0%BB%D0%BE%D0%B6%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D1%8C_%D0%BA_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%BC%D1%83_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8E\" >Genetic predisposition to this disease<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/syndrome-opsoklonusa-mioklonusa\/#%D0%A4%D0%B0%D0%BA%D1%82%D0%BE%D1%80%D1%8B_%D1%80%D0%B8%D1%81%D0%BA%D0%B0_%D0%B2%D0%BE%D0%B7%D0%BD%D0%B8%D0%BA%D0%BD%D0%BE%D0%B2%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%B3%D0%BE_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\" >Risk factors for the development of this disease<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/syndrome-opsoklonusa-mioklonusa\/#%D0%94%D0%B8%D0%B0%D0%B3%D0%BD%D0%BE%D1%81%D1%82%D0%B8%D0%BA%D0%B0_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%B3%D0%BE_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\" >Diagnosis of this disease<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/syndrome-opsoklonusa-mioklonusa\/#%D0%9B%D0%B5%D1%87%D0%B5%D0%BD%D0%B8%D0%B5\" >Treatment<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/syndrome-opsoklonusa-mioklonusa\/#%D0%A1%D0%BF%D0%B8%D1%81%D0%BE%D0%BA_%D0%BB%D0%B5%D0%BA%D0%B0%D1%80%D1%81%D1%82%D0%B2_%D0%BF%D1%80%D0%B8%D0%BC%D0%B5%D0%BD%D1%8F%D0%B5%D0%BC%D1%8B%D1%85_%D0%B4%D0%BB%D1%8F_%D0%BB%D0%B5%D1%87%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%B3%D0%BE_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\" >List of medications used to treat this disease<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/syndrome-opsoklonusa-mioklonusa\/#%D0%9C%D0%BE%D0%BD%D0%B8%D1%82%D0%BE%D1%80%D0%B8%D0%BD%D0%B3_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\" >Disease monitoring<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/syndrome-opsoklonusa-mioklonusa\/#%D0%92%D0%BE%D0%B7%D1%80%D0%B0%D1%81%D1%82%D0%BD%D1%8B%D0%B5_%D0%BE%D1%81%D0%BE%D0%B1%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D0%B8_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\" >Age-related features of the disease<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/syndrome-opsoklonusa-mioklonusa\/#%D0%92%D0%BE%D0%BF%D1%80%D0%BE%D1%81%D1%8B_%D0%B8_%D0%BE%D1%82%D0%B2%D0%B5%D1%82%D1%8B\" >Questions and Answers<\/a><\/li><\/ul><\/nav><\/div>\n<h2><span class=\"ez-toc-section\" id=\"%D0%98%D1%81%D1%82%D0%BE%D1%80%D0%B8%D1%8F_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F_%D0%B8_%D0%B8%D0%BD%D1%82%D0%B5%D1%80%D0%B5%D1%81%D0%BD%D1%8B%D0%B5_%D0%B8%D1%81%D1%82%D0%BE%D1%80%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B8%D0%B5_%D1%84%D0%B0%D0%BA%D1%82%D1%8B\"><\/span>History of the disease and interesting historical facts<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Opsoclonus-myoclonus syndrome was first described in clinical practice in the mid-20th century. In 1965, Italian neurologists published a detailed description of this disorder, identifying him as the first person to observe patients with this syndrome. As further research progressed, it became clear that OM has a two-way connection with tumors, especially neoplastic diseases in children. In the 1980s, the first precision studies were conducted to identify the immune system as a possible participant in the pathogenesis of the syndrome. Scientific publications allowed the development of recommendations for diagnosis and treatment, but the mechanism of development of the syndrome remains incompletely understood.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%AD%D0%BF%D0%B8%D0%B4%D0%B5%D0%BC%D0%B8%D0%BE%D0%BB%D0%BE%D0%B3%D0%B8%D1%8F\"><\/span>Epidemiology<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>The epidemiology of opsoclonus-myoclonus syndrome shows that its prevalence varies by population and region. According to the available data, OMS is more common in children under 5 years of age, with an increase in cases in infants in recent years. According to statistics, the incidence is approximately 1-2 cases per 100,000 children per year. However, in adults, this form of the syndrome is much less common, especially in connection with associated tumors such as pneumococcal infections or neurological disorders. Key aspects important for understanding prevalence are gender differences, as boys are affected more often than girls with a ratio of approximately 2:1.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%93%D0%B5%D0%BD%D0%B5%D1%82%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B0%D1%8F_%D0%BF%D1%80%D0%B5%D0%B4%D1%80%D0%B0%D1%81%D0%BF%D0%BE%D0%BB%D0%BE%D0%B6%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D1%8C_%D0%BA_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%BC%D1%83_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8E\"><\/span>Genetic predisposition to this disease<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>The genetic predisposition to opsoclonus-myoclonus syndrome is currently poorly understood. It has been shown that some genetic mutations may contribute to the development of the syndrome, but the specific genes and the mechanism by which they are involved remain the focus of research projects. It has been established that possible genes involved may include genes responsible for the immune response, as well as genetic abnormalities associated with neuroblastoma. Research also suggests that familial cases of OM may have a more complex pathogenesis associated with hereditary predispositions.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%A4%D0%B0%D0%BA%D1%82%D0%BE%D1%80%D1%8B_%D1%80%D0%B8%D1%81%D0%BA%D0%B0_%D0%B2%D0%BE%D0%B7%D0%BD%D0%B8%D0%BA%D0%BD%D0%BE%D0%B2%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%B3%D0%BE_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\"><\/span>Risk factors for the development of this disease<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Risk factors for the development of opsoclonus-myoclonus syndrome include both physical and chemical factors. Physical factors include:<\/p>\n<ul>\n<li>viral and bacterial infections, especially in children;<\/li>\n<li>environmental factors such as pollution;<\/li>\n<li>genetic predisposition, including cases in families.<\/li>\n<\/ul>\n<p>As for chemical factors, the following are noted:<\/p>\n<ul>\n<li>exposure to toxic substances such as pesticides;<\/li>\n<li>complications after vaccination, although this issue remains controversial;<\/li>\n<li>use of certain medications that have neurological side effects.<\/li>\n<\/ul>\n<p>Additionally, other socioeconomic and environmental aspects that may influence the overall health of children and the risk of developing the syndrome must be taken into account.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%94%D0%B8%D0%B0%D0%B3%D0%BD%D0%BE%D1%81%D1%82%D0%B8%D0%BA%D0%B0_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%B3%D0%BE_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\"><\/span>Diagnosis of this disease<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Diagnosis of opsoclonus-myoclonus syndrome is based on clinical manifestations and complex studies. The main symptoms of this disease include:<\/p>\n<ul>\n<li>continuous or paroxysmal myoclonus;<\/li>\n<li>opsoclonus, which is characterized by uncontrolled horizontal eye movements;<\/li>\n<li>ataxia resulting in impaired coordination;<\/li>\n<li>mental changes including confusion.<\/li>\n<\/ul>\n<p>Laboratory tests may include tests for anti-tumor markers such as neuroblastoma antigens. Radiological examinations such as MRI or CT scans may help identify possible tumors associated with the syndrome. Other diagnostics may include EEG to assess cortical activity. The differential diagnosis requires exclusion of other neurological disorders such as epilepsy or hereditary diseases, highlighting the importance of a comprehensive and multidisciplinary approach.<\/p><script data-noptimize=\"\" data-wpfc-render=\"false\">\nfpm_start( \"true\" );\n<\/script>\n\n<h2><span class=\"ez-toc-section\" id=\"%D0%9B%D0%B5%D1%87%D0%B5%D0%BD%D0%B8%D0%B5\"><\/span>Treatment<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Treatment of opsoclonus-myoclonus syndrome involves a multifaceted approach. In general, therapy includes:<\/p>\n<ul>\n<li>pharmacological treatment with drugs aimed at reducing the frequency of attacks;<\/li>\n<li>psychotherapeutic assistance to maintain psycho-emotional status;<\/li>\n<li>physiotherapy to improve coordination of movements;<\/li>\n<li>surgical intervention in cases of the presence of a tumor associated with the syndrome.<\/li>\n<\/ul>\n<p>Pharmacological treatment often includes corticosteroids, benzodiazepines, and anticonvulsants. Surgery is usually required in the presence of neuroblastoma to treat the underlying cause of the syndrome. Other therapies, such as rehabilitation, may also be helpful in restoring function.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%A1%D0%BF%D0%B8%D1%81%D0%BE%D0%BA_%D0%BB%D0%B5%D0%BA%D0%B0%D1%80%D1%81%D1%82%D0%B2_%D0%BF%D1%80%D0%B8%D0%BC%D0%B5%D0%BD%D1%8F%D0%B5%D0%BC%D1%8B%D1%85_%D0%B4%D0%BB%D1%8F_%D0%BB%D0%B5%D1%87%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%B3%D0%BE_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\"><\/span>List of medications used to treat this disease<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>The main groups of drugs used for opsoclonus-myoclonus syndrome include:<\/p>\n<ul>\n<li>Corticosteroids - prednisolone;<\/li>\n<li>Anticonvulsants - valproic acid, lamotrigine;<\/li>\n<li>Benzodiazepines \u2013 diazepam, clonazepam;<\/li>\n<li>Immunosuppressants - methotrexate;<\/li>\n<li>Neuroleptics - clozapine for mental status disorders.<\/li>\n<\/ul>\n<p>Each drug has its own indications and contraindications, and treatment should be selected individually for each patient.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%9C%D0%BE%D0%BD%D0%B8%D1%82%D0%BE%D1%80%D0%B8%D0%BD%D0%B3_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\"><\/span>Disease monitoring<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Monitoring of patients with opsoclonus-myoclonus syndrome includes regular observation of the dynamics of symptoms, evaluation of the effectiveness of therapy and control of possible complications. Control stages may be as follows:<\/p>\n<ul>\n<li>regular neurological examinations;<\/li>\n<li>examinations for tumors every 3-6 months;<\/li>\n<li>psycho-emotional monitoring;<\/li>\n<li>laboratory tests to monitor the state of cellular immunity.<\/li>\n<\/ul>\n<p>The prognosis with timely diagnosis and adequate therapy can be favorable, but the risks of relapse and the possibility of complications, such as persistent changes in neurological status, should be taken into account.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%92%D0%BE%D0%B7%D1%80%D0%B0%D1%81%D1%82%D0%BD%D1%8B%D0%B5_%D0%BE%D1%81%D0%BE%D0%B1%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D0%B8_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\"><\/span>Age-related features of the disease<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Opsoclonus-myoclonus syndrome has different manifestation features depending on the age group. In children, the disease may manifest itself more aggressively and require immediate diagnosis and treatment. Adult patients may also have the syndrome in the form of secondary neurological disorders, which requires a different approach to therapy, in particular, the presence of concomitant diseases should be taken into account. In old age, the syndrome may be combined with other neurological disorders, complicating its diagnosis and treatment.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%92%D0%BE%D0%BF%D1%80%D0%BE%D1%81%D1%8B_%D0%B8_%D0%BE%D1%82%D0%B2%D0%B5%D1%82%D1%8B\"><\/span>Questions and Answers<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<ul>\n<li><strong>What is opsoclonus-myoclonus syndrome?<\/strong> It is a rare neurological disorder characterized by myoclonus and opsoclonus, often associated with tumors.<\/li>\n<li><strong>What is the cause of the syndrome?<\/strong> The causes are not fully understood, but tumors, infections, and genetic factors may play a role in the pathogenesis.<\/li>\n<li><strong>How is this syndrome diagnosed?<\/strong> Diagnosis includes examination by a neurologist, neuroimaging, laboratory tests and differential diagnosis.<\/li>\n<li><strong>What treatment is recommended for opsoclonus-myoclonus syndrome?<\/strong> Treatment includes pharmacological agents, physical therapy and, if necessary, surgery.<\/li>\n<li><strong>What is the prognosis for patients with this syndrome?<\/strong> The prognosis depends on timely diagnosis and adequate therapy and can be favorable, but requires regular monitoring.<\/li>\n<\/ul>\n<div class=\"fpm_end\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Opsoclonus-myoclonus syndrome (OMS) is a rare neurological disorder characterized by paroxysmal attacks of myoclonus (sudden, brief muscle contractions) and opsoclonus (uncontrollable<\/p>","protected":false},"author":1,"featured_media":21492,"comment_status":"open","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[298],"tags":[],"class_list":["post-12388","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medlibrary"],"_links":{"self":[{"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/posts\/12388","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/comments?post=12388"}],"version-history":[{"count":1,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/posts\/12388\/revisions"}],"predecessor-version":[{"id":14691,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/posts\/12388\/revisions\/14691"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/media\/21492"}],"wp:attachment":[{"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/media?parent=12388"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/categories?post=12388"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/tags?post=12388"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}