title: Narcolepsy with cataplexy as presenting symptom of occult neuroblastoma.
abstract: Neuroblastoma associated with the paraneoplastic syndrome of opsoclonus-myoclonus is well-described. However, presentation with narcolepsy-cataplexy is not well-documented in the literature. Narcolepsy with cataplexy is also rare in children younger than 5 years of age. Here we describe three patients, each presenting in early childhood with complex neurological symptoms including narcolepsy with cataplexy that were subsequently found to have paraspinal neuroblastoma. In two of the cases, neurological symptoms resolved with treatment of the tumor and/or immunosuppression, but in one case, the child persistently had a devastating course despite complete resection of the tumor and aggressive immunosuppression.
authors.affiliation: Division of Child Neurology, Comer Children's Hospital, University of Chicago, Chicago, IL, USA. sinsioco@uic.edu
authors.forename: Claudine
authors.initials: C
authors.lastname: Sinsioco
authors.forename: Kenneth
authors.initials: K
authors.lastname: Silver
authors.forename: Katharine M
authors.initials: KM
authors.lastname: Forrest
authors.forename: Juliet
authors.initials: J
authors.lastname: Gray
authors.forename: Alla
authors.initials: A
authors.lastname: Nechay
authors.forename: Stephen
authors.initials: S
authors.lastname: Sheldon
authors.forename: Ewa
authors.initials: E
authors.lastname: Chelmicka Schorr
mesh_terms: D002385:Cataplexy / Q000175:diagnosis* / Q000209:etiology; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D009290:Narcolepsy / Q000175:diagnosis* / Q000209:etiology; D009382:Neoplasms, Unknown Primary / Q000150:complications / Q000175:diagnosis*; D009447:Neuroblastoma / Q000150:complications / Q000175:diagnosis*