Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, Denmark.
Department of Ophthalmology, Copenhagen University Hospital, Rigshospitalet-Glostrup, Denmark.
Eye (Lond). 2024 Mar;38(4):766-772. doi: 10.1038/s41433-023-02771-x. Epub 2023 Oct 10.
The aim of the study was to evaluate the prevalence, clinical characteristics, and diagnostic importance of nystagmus in children with brain tumours.
A nation-wide retrospective review of all children diagnosed with a brain tumour between January the 1st, 2007 and December 31st, 2017, in Denmark. Data is based on information from the Danish Childhood Cancer Registry, hospital records from paediatric- and ophthalmological departments, and records from private ophthalmologists.
Nystagmus was observed in 13.7% (60/437) of children with a brain tumour. In 50/60 children (83.3%) nystagmus was an incidental finding at the clinical examination and only in 10/60 children (16,7%) were nystagmus noticed by patient/caregivers prior to the clinical examination. In 38/60 children nystagmus was observed before the brain tumour diagnosis, most often (16/38, 42%) the same day as the diagnosis was made. In 22/60 children nystagmus was found after the brain tumour diagnosis (prior to any treatment) with a median of four days (range 0-47) after the brain tumour diagnosis. Nystagmus was most commonly binocular (56/60, 93.3%) and gaze-evoked (43/60, 71.7%). The median number of additional symptoms and/or clinical findings was five (range 0-11).
Nystagmus is frequent in children with brain tumours and is typically accompanied by other symptoms and clinical signs. However, nystagmus is often first recognized by the ophthalmologist late in the time course. Therefore, raising awareness of the importance of looking for nystagmus in children with unspecific neurological symptoms might contribute to increased suspicion of brain tumour and thereby faster diagnosis.
本研究旨在评估脑肿瘤患儿眼球震颤的发生率、临床特征和诊断意义。
对丹麦 2007 年 1 月 1 日至 2017 年 12 月 31 日期间诊断为脑肿瘤的所有儿童进行全国性回顾性研究。该研究基于丹麦儿童癌症登记处、儿科和眼科部门的医院记录以及私人眼科医生的记录。
在 437 例脑肿瘤患儿中，有 13.7%（60/437）出现眼球震颤。在 60 例眼球震颤患儿中，50 例（83.3%）为临床检查时偶然发现，仅 10 例（16.7%）由患儿/照顾者在临床检查前发现。在 38 例患儿中，眼球震颤在脑肿瘤诊断前出现，其中大多数（16/38，42%）与诊断日同时出现。在 60 例患儿中，有 22 例（40%）在脑肿瘤诊断后（在任何治疗之前）出现眼球震颤，中位发病时间为脑肿瘤诊断后 4 天（范围 0-47 天）。60 例眼球震颤患儿中，56 例（93.3%）为双眼性，43 例（71.7%）为注视性。此外，中位数为 5 项（范围 0-11 项）其他症状和/或临床体征。
脑肿瘤患儿眼球震颤发生率较高，通常伴有其他症状和体征。然而，眼球震颤通常由眼科医生在病程后期首次发现。因此，提高对不明原因神经系统症状患儿眼球震颤重要性的认识，可能有助于提高对脑肿瘤的怀疑，从而更快地进行诊断。
