Long-term neurobehavioral outcomes in children with neuroblastoma and opsoclonus-myoclonus-ataxia syndrome: Relationship to MRI findings and anti-neuronal antibodies

Kristen Hayward, Rita J. Jeremy, Sheila Jenkins, Anthony J. Barkovich, S. Humayun Gultekin, Joel Kramer, Mary Crittenden, Katherine K. Matthay

Research output: Contribution to journalArticle

80 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)552-559
Number of pages8
JournalJournal of Pediatrics
Volume139
Issue number4
DOIs
StatePublished - Jan 1 2001

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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    Hayward, K., Jeremy, R. J., Jenkins, S., Barkovich, A. J., Gultekin, S. H., Kramer, J., Crittenden, M., & Matthay, K. K. (2001). Long-term neurobehavioral outcomes in children with neuroblastoma and opsoclonus-myoclonus-ataxia syndrome: Relationship to MRI findings and anti-neuronal antibodies. Journal of Pediatrics, 139(4), 552-559. https://doi.org/10.1067/mpd.2001.118200