title: [Neurologic symptoms in the course of neuroblastoma in children. Own observations].
abstract: BACKGROUND
  Neurological origin and multiple localization of neuroblastoma (NB) in children predisposed to the occurrence of neurological deficits. They usually present as symptoms of spinal cord compression, peripheral nerve palsy or central nervous system metastases. The aim of the study was to analyze retrospectively the frequency and characteristics of neurological disorders in patients with NB, treated in the Department of Paediatrics, Oncology, Haematology and Endocrinology, Medical University of Gdansk, Poland, between 1992 and 2004.
  
  
  METHODS
  53 children with NB, aged 1 month to 10 years 10 months were included in the study.
  
  
  RESULTS
  Neurological symptoms were present in 16 children (30%), all with advanced NB (stages III and IV). In 12 of them neurological deficits predominated in the medical history, contributing to the neoplasm's diagnosis. Most of the patients (10 children) demonstrated symptoms of the lower limbs paresis and bladder/bowel sphincter dysfunction. Four children suffered from severe back pain. Mentioned neurological disorders preceeded NB diagnosis for median period of 2,5 months. In three patients neurological complications of surgical tumour resection occurred (Horner syndrome in two and foot dorsiflexorparesis in one child). No neurological side effects of chemo- and radiotherapy were observed. Neurological symptoms recovered completely with oncological treatment in eight patients, while in three a considerable neurological improvement was observed. No recovery of neurological deficits was obtained in patients with post-surgical complications and in children suffering from disease progression. Three patients died of NB dissemination, 13 children are alive including two patients undergoing therapy.
  
  
  CONCLUSIONS
  1. Most of NB patients recovered completely or partly from neurological disorders while on therapy. Persistent symptoms of neurogenic bladder with accompanying urinary tract infections constitute a considerable clinical problem in some children. 2. NB survivors require intensive interdisciplinary medical care of paediatric oncologist, neurologist, and nephrologist.
authors.affiliation: Klinika Pediatrii, Hematologii, Onkologii i Endokrynologii AM w Gdańsku. kasiapolczynska@wp.pl
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Połczyńska
authors.forename: Ewa
authors.initials: E
authors.lastname: Bień
authors.forename: Joanna
authors.initials: J
authors.lastname: Stefanowicz
authors.forename: Elzbieta
authors.initials: E
authors.lastname: Drozyńska
authors.forename: Anna
authors.initials: A
authors.lastname: Szołkiewicz
authors.forename: Teresa
authors.initials: T
authors.lastname: Stachowicz-Stencel
authors.forename: Danuta
authors.initials: D
authors.lastname: Sierota
authors.forename: Barbara
authors.initials: B
authors.lastname: Kaczorowska-Hać
authors.forename: Wojciech
authors.initials: W
authors.lastname: Kosiak
authors.forename: Anna
authors.initials: A
authors.lastname: Balcerska
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009422:Nervous System Diseases / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D009423:Nervous System Neoplasms / Q000556:secondary* / Q000628:therapy; D009447:Neuroblastoma / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000556:secondary* / Q000628:therapy; D010291:Paresis / Q000209:etiology / Q000628:therapy; D011044:Poland; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013117:Spinal Cord Compression / Q000209:etiology / Q000628:therapy; D016019:Survival Analysis; D014552:Urinary Tract Infections / Q000209:etiology / Q000628:therapy