The management of patients with neuroblastoma mandates an understanding of the unique biology, anatomic distribution, and the signs and symptoms that can ensue. The tumor, its treatment, and the host response to the tumor can result in a myriad of neurologic complications, both acute and long term. Isolated CNS relapses are increasingly recognized as a complication of metastatic neuroblastoma occurring in the first 1-2 years after diagnosis. Because of the poor reversibility of neuronal damage, early detection and intervention of neurologic complications using an interdisciplinary approach are critical in minimizing late sequelae, implementing effective palliation, and maximizing quality of life. Clearly, treatment decisions must be based on the patient's age and long-term prognosis.

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