The neurologic and developmental outcomes in 10 children with opsoclonus-myoclonus (“dancing eyes syndrome”) and neuroblastoma were reviewed by examination of records at Northwestern University Medical School and Children’s Memorial Hospital, and the University of Illinois Hospital, Chicago.
The neurologic and developmental outcomes in 10 children with opsoclonus-myoclonus (“dancing eyes syndrome”) and neuroblastoma were reviewed by examination of records at Northwestern University Medical School and Children’s Memorial Hospital, and the University of Illinois Hospital, Chicago. Ages ranged from 8 months to 30 months. Opsoclonus and ataxia had been present from 6 days to 1 year before diagnosis of neuroblastoma. All had localized disease and 50% had extraabdominal tumors. All are alive and without recurrence of tumor 8 months to 111 months after resection. All had opsoclonus-myoclonus or ataxia for at least 5 months after surgery, but eventually responded to ACTH therapy. Two were symptom-free 12 months after surgery, and 3 remitted after 36 months. Nine relapsed and had chronic deficits, including cognitive and motor delays, reading and language deficits, and behavioral abnormalities. Factors precipitating recurrences of opsoclonus-myoclonus or ataxia included discontinuance or reduction of ACTH, febrile illness, and immunizations. [
COMMENT. All children with neuroblastoma and opsoclonus-myoclonus and ataxia had an excellent surgical outcome and their eye movement disorder eventually responded to ACTH. The majority have long-term learning and behavioral problems, requiring special remedial education and behavioral intervention. Immunizations should be delayed or withheld when possible to avoid relapse of opsoclonus and ataxia.