title: Neurological complications of neuroblastic tumors: experience of a single center.
abstract: OBJECTIVE
  This study aims to evaluate the prevalence and clinical characteristics of neurological complications in patients with newly diagnosed neuroblastic tumors (NT).
  
  
  METHODS
  Hospital file search was performed in patients with NT, and neurological complications, clinical, and treatment features were analyzed.
  
  
  RESULTS
  Out of 523 patients with NT, 19 patients had Horner's syndrome, 9 patients had opsoclonus-myoclonus-ataxia syndrome (OMA), 11 patients had central nervous system (CNS) involvement, and 49 patients had spinal cord compression (SCC) at diagnosis. During follow-up, seven more patients had CNS metastases. Survival rates were poor in patients with CNS involvement; all died at a median of 7.9 months after diagnosis. The neurological symptoms and signs of patients with SCC were mild, moderate, and severe in 13, 9, and 22 patients, respectively. Sphincter deficiency and sensory loss were diagnosed in 52.3% and 43.2% of patients. The neurological deficits of 11/17 patients who had symptoms less than 4 weeks were completely resolved or improved. The incidence of sequelae after laminectomy, radiotherapy, and chemotherapy were 46.2%, 66.6%, and 13.6%, respectively.
  
  
  CONCLUSIONS
  The prevalence rates of Horner's syndrome, OMA, CNS metastasis, and SCC were found to be 3.6%, 1.8%, 2.2%, and 9.4%, respectively. Metastasis to the CNS indicated a very poor prognosis. No differences in neurological improvement in patients with SCC were found between those treated with radiotherapy, laminectomy, or chemotherapy alone, but laminectomy and radiotherapy caused significant late sequelae. Early diagnosis and proper management is critical to avoid long-term sequelae in patients with SCC.
authors.affiliation: Department of Pediatric Oncology, Ankara Oncology Research Hospital, 06070, Demetevler, Ankara, Turkey. burcaaydin@yahoo.com
authors.forename: G Burca
authors.initials: GB
authors.lastname: Aydin
authors.forename: M Tezer
authors.initials: MT
authors.lastname: Kutluk
authors.forename: Munevver
authors.initials: M
authors.lastname: Buyukpamukcu
authors.forename: Canan
authors.initials: C
authors.lastname: Akyuz
authors.forename: Bilgehan
authors.initials: B
authors.lastname: Yalcin
authors.forename: Ali
authors.initials: A
authors.lastname: Varan
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D009422:Nervous System Diseases / Q000150:complications* / Q000453:epidemiology* / Q000628:therapy; D009447:Neuroblastoma / Q000150:complications* / Q000453:epidemiology* / Q000628:therapy; D015995:Prevalence; D012189:Retrospective Studies; D016896:Treatment Outcome