Erkin RAHİMOV, Mine ÇALIŞKAN, Barış EKİCİ

Opsomiyoklonus ve Ataksi: Nöroblastomun Kalıcı Olabilen Nörolojik Sorunu

Sütçocuğu döneminde akut ataksi çoğu kez viral infeksi- yonlar, ilaç intoksikasyonları ve intrakraniyal tümörlere bağlı olarak gelişir. Akut serebellar ataksi ve opsomiyok- lonus birlikteliği nöroblastomun ilk belirtisi olabilir. On dokuz aylık erkek hasta, 10 gün önce başlayan yürürken düşme, dengesizlik ve ellerde titreme yakınmaları ile geti- rildi. Hastanın nöron spesifik enolaz değeri 48 ng/ml normal değeri

Anahtar Kelimeler:

Nöroblastoma, ataksi, OpsoklonusMiyoklonus sendromu

Opsomyoclonus and Ataxia: Possibly Permanent Neurological Conditions Caused by Neuroblastoma

Acute ataxia in infants may develop due to viral infections, drug intoxication, intercranial lesions. One of the first symptoms of neuroblastoma can be the combination of acute cerebral ataxia, and opsomyoclonus. A 19-month old male infant was admitted with complaints of ataxia, loss of balance and hand tremors. The neuron-specific enolase test revealed an increased level of 48 ng/ml the normal level being

Keywords:

Neuroblastoma, ataxia, Opsoclonus-Myoclonus syndrome,

PDF

___

1. Williams TH, House RF Jr, Burget EO Jr, Lynn HB. Unusual manifestations of neuroblastoma: chronic diarrhea, polimioclonia-opsoclonus, an erytrocyte abnormalities. Cancer 1972;29(2):475-80. http://dx.doi.org/10.1002/1097-0142(197202)29:23.0.CO;2-I
2. Orzechowski C. De l’ataxie dysmetrique des yeux: remarques sur l’ataxie des yeux dite myoclonique (opsoclonie, opsochorie). J Psychol Neurol 1927;35:1-18.
3. Kinsbourne M. Miyoclonic encephalopathy of infants. J Neurol Neurosurg Psychiatry 1962;25(3):271-6. http://dx.doi.org/10.1136/jnnp.25.3.271 PMid:50411
4. Solomon GE, Chutorian AM. Opsoclonus and occult neuroblastoma. N Engl J Med 1968;279(9):475-7 http://dx.doi.org/10.1056/NEJM196808292790907 PMid:5663722
5. Altman AJ, Baehner RL. Favourable prognosis fot survival in children with coincident opso-myoclonus and neuroblastoma. Cancer 1976;37(4):846-52 http://dx.doi.org/10.1002/1097-0142(197602)37:23.0.CO;2-L
6. Keating JW, Cromwell LD. Remote effects of neuroblastoma. AJR 1978;131(2):299-303 PMid:98012
7. Rothenberg AB, Berdon WE, D’Angio GJ, Yamashiro DJ, Cowles RA. The association between neuroblastoma and opsoclonus-myoclonus syndrome: a historical review. Pediatr Radiol 2009;39(7):723-6. http://dx.doi.org/10.1007/s00247-009-1282-x PMid:19430769
8. Aydin GB, Kutluk MT, Buyukpamukcu M, Akyuz C, Yalcin B, Varan A. Neurological complications of neuroblastic tumors: experience of a single center. Childs Nerv Syst 2010;26(3):359-65 http://dx.doi.org/10.1007/s00381-009-0979-3 PMid:19714340
9. Korobkim M, Clark RE, Palubinskas AJ. Occult neuroblastoma and acute cerebellar ataxia in childhood. Radiology 1972;102(1):151-2. PMid:5008138
10. Sandok BA, Kranz H. Opsoclonus as initial manifestation occult neuroblastoma. Arch Ophthalmol 1971;86(2):235-6. http://dx.doi.org/10.1001/archopht.1971.01000010237018 PMid:4328390
11. Robert L. Telander, William A. Smithson, Robert V. Groover. Clinical outcome in children with Acute Cerebellar Encephalopathy and Neuroblastoma, Neuroblastoma associated with seizures and arrested development. J Ped Neurol 1990;221(9):57-9.
12. Bray PF, Ziter FA, Lahey ME, Myers CG. The coincidence of neuroblastoma and acute cerebellar encephalopathy. J Pediatr 1969;75(6):983-90. http://dx.doi.org/10.1016/S0022-3476(69)80335-5
13. Farrelly C, Daneman A, Chan HSL, et al. Occult neuroblastoma presenting with opsomyoclonus: utility of computed tomography. AJR 1984;142(4):807-10. PMid:6608244
14. Mitchell WG, Davalos-Gonzalez Y, Brumm VL, et al. Opsoclonus-ataxia caused by childhood neuroblastoma: developmental and neurologic sequelae. Pediatrics 2002;109(1): 86-98. PMid:11773546
15. Matthay KK, Blaes F, Hero B, et al. Opsoclonus myoclonus syndrome in neuroblastoma a report from a workshop on the dancing eyes syndrome at the advances in neuroblastoma meeting in Genoa, Italy, 2004. Cancer Lett 2005;228(1- 2):275-82. http://dx.doi.org/10.1016/j.canlet.2005.01.051 PMid:15922508