A nationwide survey of opsoclonus-myoclonus syndrome in Japanese children

Japanese Society for Pediatric Immune-mediated Brain Diseases

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29 Citations (Scopus)

Abstract

Background: Opsoclonus-myoclonus syndrome (OMS) is a rare neurological disease characterized by opsoclonus, myoclonus, ataxia, and behavioral changes. The aim of our study was to investigate the epidemiological characteristics of OMS in Japan and to clarify the association between therapy and prognosis. Methods: We retrospectively collected the data from 626 Japanese medical institutions from 2005 to 2010, and analyzed the clinical features of pediatric patients with OMS based on the data. Results: In this survey, there were 23 patients (10 males and 13 females). The median ages at the disease onset and the time of study were 16.5. months (range: 11-152. months) and 54. months (range: 24-160. months), respectively. The principal symptoms were opsoclonus (23 patients, 100%), myoclonus (21 patients, 91.3%), and ataxia (23 patients, 100%). The related factors were neuroblastoma (10, 43.5%), infection (9, 39.1%), and immunization (2, 8.7%). The treatments for OMS were included intravenous immunoglobulin (17, 73.9%), methylprednisolone pulse (13, 56.5%), oral prednisolone (12 patients, 52.2%), and chemotherapy and/or operation for the underlying tumors (6, 26.1%), and rituximab (2, 8.7%). Complete remissions were obtained in 35.3%, 23.1%, 33.3%, 66.7%, and 100% of these treatments, respectively. At the latest follow-up period, 8 (34.8%) and 17 patients (73.9%) showed neurological sequelae of motor and intellectual functions, respectively. Patients whose treatment was started more than 30. weeks after the disease onset suffered from the severest neurological sequelae (OMS severity 4) more frequently than those less than 30. weeks (. p=. 0.022). Conclusion: The annual incidence of OMS was estimated to be 0.27-0.40 cases per million in Japanese children. More than 70% of OMS patients had neurological sequelae, especially intellectual function. Early effective treatments within 30. weeks after the onset may be required to prevent the serious neurological outcome.

Original languageEnglish
Pages (from-to)656-660
Number of pages5
JournalBrain and Development
Volume37
Issue number7
DOIs
Publication statusPublished - Aug 1 2015

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Developmental Neuroscience
  • Clinical Neurology

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