TY - JOUR
T1 - Long-term neurobehavioral outcomes in children with neuroblastoma and opsoclonus-myoclonus-ataxia syndrome
T2 - Relationship to MRI findings and anti-neuronal antibodies
AU - Hayward, Kristen
AU - Jeremy, Rita J.
AU - Jenkins, Sheila
AU - Barkovich, Anthony J.
AU - Gultekin, S. Humayun
AU - Kramer, Joel
AU - Crittenden, Mary
AU - Matthay, Katherine K.
N1 - Funding Information:
Supported by Tkalcevic and Kasle Neuroblastoma Research Fund, Campini Foundation, and Conner Fund; Pediatric Clinical Research Center, NIH no. M01RR01271; and UCSF School of Medicine Dean’s Grant for Student Research.
PY - 2001
Y1 - 2001
N2 - Objectives: Opsoclonus-myoclonus-ataxia (OMA) syndrome affects 2% to 3% of patients with neuroblastoma. This study examined relationships between long-term neurobehavioral outcomes and potential biologic markers of OMA, including chronic changes on magnetic resonance imaging (MRI) brain scanning and prevalence of late antineuronal antibodies. Study design: Children with neuroblastoma and OMA were identified through medical record review of patients treated at the University of California at San Francisco Medical Center from 1979 to 1999. Eleven patients with a mean follow-up time of 7.6 years underwent standard neurologic, neurocognitive/developmental, behavioral, and academic assessments. Consenting patients underwent MRI brain scanning and a blood draw. Sera were analyzed for the presence of antineuronal immunoreactivity. Results: Two (18%) patients had no observed neurologic abnormalities, 7 (64%) demonstrated mild deficits, and 2 (18%) had severe neurologic deficits. However, on neurocognitive, behavioral, and academic assessments, 6 (55%) children performed within the average range, 1 (9%) was moderately below average and 4 (36%) had severe cognitive and behavioral deficiencies. Brain MRI in 5 of 5 patients was notable for cerebellar atrophy without supratentorial involvement. Antineuronal activity was detected in sera of 0 of 10 children at follow-up. Conclusions: Certain patients with neuroblastoma associated OMA may achieve average-range neurobehavioral function in spite of residual neurologic abnormalities, with suggestion of continued improvement over time. Late cerebellar atrophy appears to be a common finding regardless of neurologic outcome, whereas antineuronal immune reactivity does not appear to be a long-term feature of OMA.
AB - Objectives: Opsoclonus-myoclonus-ataxia (OMA) syndrome affects 2% to 3% of patients with neuroblastoma. This study examined relationships between long-term neurobehavioral outcomes and potential biologic markers of OMA, including chronic changes on magnetic resonance imaging (MRI) brain scanning and prevalence of late antineuronal antibodies. Study design: Children with neuroblastoma and OMA were identified through medical record review of patients treated at the University of California at San Francisco Medical Center from 1979 to 1999. Eleven patients with a mean follow-up time of 7.6 years underwent standard neurologic, neurocognitive/developmental, behavioral, and academic assessments. Consenting patients underwent MRI brain scanning and a blood draw. Sera were analyzed for the presence of antineuronal immunoreactivity. Results: Two (18%) patients had no observed neurologic abnormalities, 7 (64%) demonstrated mild deficits, and 2 (18%) had severe neurologic deficits. However, on neurocognitive, behavioral, and academic assessments, 6 (55%) children performed within the average range, 1 (9%) was moderately below average and 4 (36%) had severe cognitive and behavioral deficiencies. Brain MRI in 5 of 5 patients was notable for cerebellar atrophy without supratentorial involvement. Antineuronal activity was detected in sera of 0 of 10 children at follow-up. Conclusions: Certain patients with neuroblastoma associated OMA may achieve average-range neurobehavioral function in spite of residual neurologic abnormalities, with suggestion of continued improvement over time. Late cerebellar atrophy appears to be a common finding regardless of neurologic outcome, whereas antineuronal immune reactivity does not appear to be a long-term feature of OMA.
UR - http://www.scopus.com/inward/record.url?scp=0034781738&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0034781738&partnerID=8YFLogxK
U2 - 10.1067/mpd.2001.118200
DO - 10.1067/mpd.2001.118200
M3 - Article
C2 - 11598603
AN - SCOPUS:0034781738
SN - 0022-3476
VL - 139
SP - 552
EP - 559
JO - Journal of Pediatrics
JF - Journal of Pediatrics
IS - 4
ER -