Congenital neuroblastoma presenting with paraplegia.

Munro, Fraser D.; Carachi, Robert; Fyfe, Alasdair H.B.

doi:10.1136/adc.66.10.1246

Cited by 16 publications

(5 citation statements)

References 6 publications

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“…However, four of the six children with ongoing neurological problems in their study had deficits present at birth 22. Munro et al found a similarly poor neurological outlook for children with congenital paraplegia secondary to neuroblastoma 23. One of our patients had reduced fetal movements at 28 weeks of gestation on ultrasound scan, and had probably had had spinal cord compression for three months by the time of delivery.…”

Section: Discussionsupporting

confidence: 46%

Neonatal neuroblastoma

Moppett

Haddadin

Foot

1999

Archives of Disease in Childhood - Fetal and Neonatal Edition

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Over nine years, 33 children with neonatal neuroblastoma were registered with the UKCCSG (United Kingdom Children's Cancer Study Group). Tumours of all stages were found, but stage 4S disease predominated. Five tumours were detected prenatally by ultrasonography. Treatment varied according to tumour stage. The overall survival of the group was 91%. Ten children have had long term complications as a result of their disease, usually as a result of spinal tumour involvement. The good overall prognosis in this age group is encouraging, but the poor neurological outcome of patients with intraspinal extension is of concern. (Arch Dis Child Fetal Neonatal Ed 1999;81:F134-F137)

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Section: Discussionsupporting

confidence: 46%

Neonatal neuroblastoma

Moppett

Haddadin

Foot

1999

Archives of Disease in Childhood - Fetal and Neonatal Edition

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“…There is neuropathological evidence for spinal-cord injury due to perinatal hypoxic-ischaemic events (Sladky and Rorke 1986). Spinal compression due to congenital neuroblastoma always needs to be excluded (Munro et al 1991).…”

Section: Discussionmentioning

confidence: 99%

“…Cases have been described after intrauterine trauma (Weyerts et al 1992) and spinal-cord tumours (Munro et al 1991). We describe a possible new association.…”

mentioning

confidence: 99%

Congenital paraplegia following maternal hypotension

Suri¹,

Salfield²,

Baxter

1999

Develop Med Child Neuro

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Congenital paraplegia, with partial improvement over the first months of life, occurred in a female neonate born at 35 weeks' gestation, whose mother had suffered hypotension and hypoxaemia due to anaphylaxis 12 weeks earlier. Our patient subsequently had an acute encephalopathy during a respiratory illness with later developmental delay. We speculate that the baby's paraplegia resulted from spinal-cord ischaemia in utero. The aim of this report is to describe the spinal presentation.Congenital paraplegia due to causes other than spina bifida is rare. Cases have been described after intrauterine trauma (Weyerts et al. 1992) and spinal-cord tumours (Munro et al. 1991). We describe a possible new association. Case reportA 32-year-old mother was diagnosed with Grade 3 carcinoma of the breast during her third pregnancy. At 23 weeks' gestation, she had an anaphylactic reaction to suxamethonium during an attempted mastectomy; she suffered hypotension (lowest blood pressure 70/44 mmHg) and hypoxaemia (least oxygen saturation 70 to 80%) during a 30-minute period. Surgery was carried out successfully a week later. Her pregnancy was otherwise uneventful until delivery by lower-segment caesarean section at 35 weeks' gestation.Our patient had Apgar scores of 9 at 1 minute and 10 at 5 minutes. At birth, bilateral lower-limb deformity was present; flexed hips, hyperextended knees, and calcaneovalgus, typical of the posture of patients with spina bifida with lesions below the third lumbar segment (L3) (Fig. 1). Abnormal skin creases were present anterior to the knee, with normal creases posteriorly, and with no dimples around the knee.There was increased flexor tone at the hips with hip-flexion contractures but without dislocation, increased extensor tone at the knees with knee extension contractures, and distal wasting. There was no voluntary or reflex hip extension, knee flexion, foot or toe movement. Knee jerks were brisk, with crossed adductor responses, but the left ankle jerk was absent and the right weakly present. There was poor response to pin-prick over the leg and the perianal area. The anus was flaccid with an absent anal wink. The spine was normal to palpation, as was neurological examination of the upper limbs and cranial nerves. The patient was treated with physiotherapy.MRI of the spine, which was marred by movement artefact, excluded spinal compression. At 2 weeks of age, ultrasound scans of the hips, spine, kidneys, and brain were

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“…Congenital neuroblastoma presenting with paraplegia is rare; though the survival is better compared to older children 2 . It is postulated that in case of congenital neuroblastoma cord compression must have occurred antenatally and by the time of birth irreversible damage have already occurred so decompression with laminectomy (with its high morbidity) may not be useful 2 . Our patient was treated with chemotherapy alone.…”

mentioning

confidence: 84%

“…Chemotherapy, radiotherapy and surgical decompression with laminectomy are different therapeutic options in the treatment of cord compression from neuroblastoma 1 . Congenital neuroblastoma presenting with paraplegia is rare; though the survival is better compared to older children 2 . It is postulated that in case of congenital neuroblastoma cord compression must have occurred antenatally and by the time of birth irreversible damage have already occurred so decompression with laminectomy (with its high morbidity) may not be useful 2 .…”

mentioning

confidence: 99%

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2011

J Paediatrics Child Health

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Congenital neuroblastoma presenting with paraplegia.

Cited by 16 publications

References 6 publications

Neonatal neuroblastoma

Neonatal neuroblastoma

Congenital paraplegia following maternal hypotension

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