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J Child Neurol. 2014 Jan;29(1):84-7. doi: 10.1177/0883073812461946. Epub 2012 Oct 30.

Seizures as a presentation of a pelvic neuroblastoma in a 5-month-old infant.

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1
1Centro de Desenvolvimento da Criança Torrado da Silva, Serviço de Pediatria, Hospital Garcia de Orta, Almada, Portugal.

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.

KEYWORDS:

developmental arrest; epilepsy; pelvic neuroblastoma; seizure

PMID:
23112240
DOI:
10.1177/0883073812461946
[Indexed for MEDLINE]
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