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患有眼阵挛-肌阵挛综合征的神经母细胞瘤患儿的长期神经学转归

Long-term neurological outcomes of children with neuroblastoma with opsoclonus-myoclonus syndrome.

作者信息

Sun Qing, Wang Yinhao, Xie Yao, Wu Penghui, Li Shuo, Zhao Weihong

机构信息

Department of Pediatrics, Peking University First Hospital, Beijing, China.

Department of Ophthalmology, Peking University Third Hospital, Beijing, China.

出版信息

Transl Pediatr. 2022 Mar;11(3):368-374. doi: 10.21037/tp-21-519.

Abstract

BACKGROUND

Neuroblastoma with opsoclonus-myoclonus syndrome (OMS-NB) is a rare disease in children. Few studies of long-term outcome of children with OMS-NB were conducted. This study aimed to review the rate of recovery of neurological symptoms and the long-term neurological outcomes of children with OMS-NB.

METHODS

This study retrospectively assessed 14 children with OMS-NB diagnosed at Peking University First Hospital from May 2011 to November 2019. Demographic data, neurological symptoms, oncological status and treatments were retrospectively reviewed from the records. Neurological sequelae were recorded by clinical and remote follow-up.

RESULTS

During the acute stage, myoclonus and ataxia were observed in all children while opsoclonus was observed in 10/14 children. The median durations of neurological symptoms were 15 months (range, 5-48 months). Approximately 93% (13/14) children revealed neurological sequelae. Significant correlations were as follows: motor retardation with female gender (P<0.001) and residual tumors (P<0.05); language impairment with non-adrenal-gland-located tumors (P<0.05). There were no obvious factors that had a statistical relationship with cognitive disorder or behavioral changes.

CONCLUSIONS

Children with OMS-NB have favorable outcomes in terms of neurological symptoms. Neurological sequelae occurred in almost all children. Children with different features tend to reveal different sequalae. Features of female gender and residual tumors tend to reveal motor retardation while that of non-adrenal-gland-located tumors tend to reveal language impairment.

摘要

背景

伴眼球运动失调-肌阵挛综合征的神经母细胞瘤(OMS-NB)是一种儿童罕见病。针对OMS-NB患儿长期预后的研究较少。本研究旨在回顾OMS-NB患儿神经症状的恢复率及长期神经学转归。

方法

本研究回顾性评估了2011年5月至2019年11月在北京大学第一医院确诊的14例OMS-NB患儿。从病历中回顾性分析人口统计学数据、神经症状、肿瘤状态及治疗情况。通过临床及远程随访记录神经后遗症。

结果

急性期,所有患儿均出现肌阵挛和共济失调,14例中有10例出现眼球运动失调。神经症状的中位持续时间为15个月(范围5 - 48个月)。约93%(13/14)的患儿存在神经后遗症。显著相关性如下:运动发育迟缓与女性性别(P<0.001)及残留肿瘤(P<0.05)相关;语言障碍与非肾上腺部位肿瘤(P<0.05)相关。没有明显因素与认知障碍或行为改变存在统计学关联。

结论

OMS-NB患儿在神经症状方面预后良好。几乎所有患儿都出现了神经后遗症。具有不同特征的患儿往往表现出不同的后遗症。女性性别和残留肿瘤特征往往与运动发育迟缓相关,而非肾上腺部位肿瘤特征往往与语言障碍相关。

相似文献

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本文引用的文献

1
Delayed Opsoclonus-Myoclonus Syndrome After Ovarian Teratoma Resection.卵巢畸胎瘤切除术后迟发性眼-阵挛-肌阵挛综合征。
J Neuroophthalmol. 2022 Mar 1;42(1):e450-e451. doi: 10.1097/WNO.0000000000001384. Epub 2021 Aug 17.
2
Opsoclonus-myoclonus-ataxia syndrome in children.儿童发作性眼球运动-肌阵挛-共济失调综合征。
J Neurol. 2022 Feb;269(2):750-757. doi: 10.1007/s00415-021-10536-3. Epub 2021 Mar 29.
10
Opsoclonus-myoclonus in children associated or not with neuroblastoma.儿童与神经母细胞瘤相关或不相关的眼震-肌阵挛。
Eur J Paediatr Neurol. 2010 Sep;14(5):400-9. doi: 10.1016/j.ejpn.2009.12.005. Epub 2010 Jan 27.

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