Neuroblastoma Presentation With Multiple Cranial Nerve Involvement
نویسندگان
چکیده
Objective NA. Background We report a case of neuroblastoma, pediatric neuroendocrine tumor the sympathetic nervous system, in 3-year-old female with multiple cranial nerve involvement. Design/Methods A afebrile, lethargic presented bilateral eyelid droop, right head tilt, slurred speech, gagging, abnormal walking and no bowel movement. Neurological examination noted ptosis, dysarthria, left tongue deviation, proximal weakness upper lower extremities, areflexia biceps patellar tendons, dysmetria, wide-based gait. MRI brain showed heterogeneous appearance clivus spine adrenal mass enhancement vertebrae, suggesting possible metastatic disease. Serum cerebrospinal studies were unremarkable. Patient was treated intravenous methylprednisolone plasmapheresis for suspected paraneoplastic syndrome; however, she continued to clinically progress. Adrenal biopsy results elevated urine VMA HVA levels consistent diagnosis neuroblastoma. Nuclear imaging meta-iodobenzylguanidine scan negative. Paraneoplastic panels Lambert Eaton panel negative autoantibodies. Total resection abdominal gland steroid taper, resulted reported near total symptom resolution. Results Our patient antibody polyneuropathy due Cranial involvement neuroblastoma can result from chain, syndromes, or metastasis skull. patient's initial suggested potential inflammatory clivus, causing her symptoms. However, nuclear disease symptoms resolved after main etiology. Although Lambert-Eaton common associated antibodies, it is likely an unmeasured autoantibody, cytokine, hormones, peptide at play. Conclusions Neuroblastoma should be considered as differential neurological presentation involving nerves child.
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ژورنال
عنوان ژورنال: Neurology
سال: 2022
ISSN: ['0028-3878', '1526-632X']
DOI: https://doi.org/10.1212/01.wnl.0000903588.17297.bf