title: Seizures as a presentation of a pelvic neuroblastoma in a 5-month-old infant.
abstract: Epilepsy is a very uncommon first manifestation of a neuroblastoma. A 5-month-old healthy infant presented with acute onset seizures and developmental regression. Extensive investigation was remarkable for urinary vanillylmandelic acid and homovanillic acid peaks. Abdominopelvic magnetic resonance imaging (MRI) disclosed a presacral unresectable pelvic neuroblastoma. Chemotherapy and monthly dexamethasone pulses were administrated. Seizures stopped 3 days after the first pulse of dexamethasone. At 3-year follow-up, the patient is asymptomatic and has normal neurologic and developmental examinations. This case illustrates an impressive clinical and electroencephalographic (EEG) improvement on corticosteroid therapy, raising several hypotheses, including the possibility of a nonclassic paraneoplastic neurologic syndrome.
authors.affiliation: 1Centro de Desenvolvimento da Criança Torrado da Silva, Serviço de Pediatria, Hospital Garcia de Orta, Almada, Portugal.
authors.forename: Cristina L
authors.initials: CL
authors.lastname: Martins
authors.forename: José Paulo
authors.initials: JP
authors.lastname: Monteiro
authors.forename: Filomena
authors.initials: F
authors.lastname: Pereira
authors.forename: Paulo
authors.initials: P
authors.lastname: Calhau
authors.forename: Maria José
authors.initials: MJ
authors.lastname: Fonseca
mesh_terms: D000005:Abdomen / Q000473:pathology; D004569:Electroencephalography; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D009447:Neuroblastoma / Q000150:complications* / Q000175:diagnosis; D010386:Pelvic Neoplasms / Q000150:complications* / Q000175:diagnosis; D012640:Seizures / Q000209:etiology*
keywords: developmental arrest; epilepsy; pelvic neuroblastoma; seizure