Volume 2002, Issue 1

Abstract

Opsoclonus myoclonus syndrome (OMS) is a very rare syndrome which presents with ataxia, opsoclonus and myoclonus. We report the combined treatment of immunoglobulins and prednisolone compared to prednisolone alone in two patients. The diagnosis was based on the clinical findings. Work up for neuroblastoma was negative in both patients. Prednisolone treatment in the first patient was associated with slow response, relapses and toxic side effects. Immunoglobulins combined with prednisolone in the second patient were effective with neither relapse nor drug side effect. The clinical findings, differential diagnosis and the management are discussed. It appears that combined therapy with prednisolone and immunoglobulin gives better results. To the best of our knowledge this is first paper from the Middle East reporting this syndrome.

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2002-06-01
2024-03-29
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References

  1. Boltshauser E, Deonna T, Hirt HR. Myoclonic encephalopathy of infa“nr dancing eyes syndrome:” report of 7 cases with long-term follow-up and review of the literature (cases with and without neuroblastoma). Helv Paediatr Acta. 1979; 34::119113.
    [Google Scholar]
  2. Solomon GE. Chutorian. Opsoclonus and occult neuroblastoma. N Engl J Med. 1968; 279::475477.
    [Google Scholar]
  3. Woods WG, Tuchman M. Neuroblastoma: The case for screening infants in North America. Pediatrics. 1987; 79::869873.
    [Google Scholar]
  4. Pochedly C, Strauss L. Histogenesis and pathology of neuroblastoma. Neuroblastoma. Acton MA: Publishing Sciences 1976;:155179.
  5. Altman AJ, Baehner RL. Favorable prognosis for survival in children with coincident op so-myoclonus and neuroblastoma. Cancer. 1976; 37::846852.
    [Google Scholar]
  6. Chiba S, Motoya H, Shinoda M, Nakao T. Myoclonic encephalopathy of infants: a report of two cases of dancing eyes syndrome. Dev Med Child Neurol. 1970; 12::767771.
    [Google Scholar]
  7. Sandok BA, Kranz H. Opsoclonus as the initial manifestation of occult neuroblastoma. Arch Ophthalmol. 1971; 86::235236.
    [Google Scholar]
  8. Glaser JS. Neurophthalmology. Philadelphia: JB Lippincott 1990:p.349.
    [Google Scholar]
  9. Dyken P, Kolar O. Dancing eyes, dancing feet: infantile polymyoclonus. Brain. 1968; 91::305320.
    [Google Scholar]
  10. Christoff N. Myoclonic encephalopathy of infants: a report of two cases and observations on related disorders. Arch Neurol. 1969; 21::229346.
    [Google Scholar]
  11. Pranzatelli MR. The immunopharmacology of the opsoclonusmyoclonus syndrome. Clin Neuropharmacol. 1996; 19::147.
    [Google Scholar]
  12. Senelick RC, Bray PF, Lahey E, Van Dyk HJL, Johnson DG. Neuroblastoma and myoclonic encephalopathy: two cases and a review of the literature. J Pediatr Surg. 1973; 8::623632.
    [Google Scholar]
  13. Kuban KC, Ephros MA, Freeman RL, Laffell LB, Bresnan MJ. Syndrome of opsoclonus-myoclonus caused by Coxsackie B3 infection. Ann Neurol. 1983; 13::6971.
    [Google Scholar]
  14. Mitchell WG, Snodgrass SR. Opsoclonus-ataxia due to childhood neural crest tumors: a chronic neurologic syndrome. J Child Neurol. 1990; 5::153158.
    [Google Scholar]
  15. Tuchman RF, Alvarez LA, Kantrowitz AB, Moser FG, Llena J, Moshe SL. Opsoclonus-myoclonus syndrome: correlation of radiographic and pathological observations. Neuroradiology. 1989; 31::250252.
    [Google Scholar]
  16. Parisi MT, Hattner RS, Matthay KK, Berg BO, Sandler ED. Optimized diagnostic strategy for neuroblastoma in opsoclonus-myoclonus. J Nucl Med. 1993; 34::19221926.
    [Google Scholar]
  17. Telander RL, Smithson WA, Grover RV. Clinical outcome in children with acute cerebellar encephalopathy and neuroblastoma. J Pediatr Surgery. 1989; 24::1114.
    [Google Scholar]
  18. Ranzatelli MR. On the molecular mechanism of adrenocorticotrophic hormone in the CNS: neurotransmitters and receptors. Exp Neurol. 1994; 125::120.
    [Google Scholar]
  19. Hammer MS. Lars en MB. Stack CV. Outcome of children with opsoclonus-myoclonus regardless of etiology. Pediatr Neurol. 1995; 13::2124.
    [Google Scholar]
  20. Russo C, Cohn SL, Petruzzi MJ, DeAlarcon PA. Long-term neurologic outcome in children with opsoclonus-myoclonus associated with neuroblastoma: a report from the Pediatric Oncology Group. Med Pediatr Oncol. 1997; 28::284288.
    [Google Scholar]
  21. Petruzzi MJ, De Alarcon PA. Neuroblastoma-associated opsoclonus-myoclonus treated with intravenously administered immune globulin G. J Pediatr. 1995; 127::328329.
    [Google Scholar]
  22. Sugie H, Sugie Y, Akimoto H, Endo K. High-dose human immunoglobulin in a case with infantile opsoclonus polymyoclonia syndrome. Acta Pediatrica. 1992; 81::371372.
    [Google Scholar]
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Keyword(s): childrenimmunoglobulins,prednisolone and Opsoclonus myoclonus syndrome

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