Laboratory Testing

There is no confirmatory laboratory test. Finding serum antibodies is helpful (Fisher et al. 1994), but children with OMS are usually seronegative by commercial testing for the paraneoplastic autoantibodies described in adults (Pranzatelli et al. 2002b). Low-serum titers of anti-Hu antibodies occur as often in neuroblastoma without OMS (Antunes et al. 2000) and do not correlate with neurologic outcome (Rud-nick et al. 2001a). Autoantibodies to post-synaptic densities or other unidentified brain antigens can be seen on Western blots, and both IgG and IgM antineurofilament antibodies have been reported in OMS (Connolly et al. 1997); however, these antibodies are not specific and are also found in widely divergent disorders (Bataller et al. 2003; Stubbs et al. 2003).

Table 13.3. Therapeutic approaches to (opsoclonus-myoclonus syndrome) OMS

Agent

Pros

Cons

Biologic factors ACTH (corticotropin)

Most potent agent for inducing neurologic remission

Must be given by injection; steroid side effects

0 0

Post a comment