Neurological

Neurological problems include paresthesias, mild to severe paresis, paraplegia, and neurogenic bladder (Pastore et al. 1982; Pastore et al. 1987). These complications are related to the disease itself (intraspinal tumors) and/or to surgery. Surgical complications in neuroblastoma are reported in 5-25% of these cases, especially when aggressive resections of thoracic or abdominal tumors were attempted (Azizkhan et al. 1985; Nitschke et al. 1988; Cruccetti et al. 2000). The incidence of intraspinal tumors is higher in children with local-regional disease than in patients with widely disseminated neuroblastoma (Katzenstein et al. 2001, De Bernardi et al. 2001, Plan-taz et al. 1996). Neurological recovery correlates inversely with the severity of the presenting neurological deficits (Hoover et al. 1999; De Bernardi et al. 2001; Katzenstein et al. 2001). Recent studies suggest that chemotherapy is as effective as laminectomy and radiation therapy for the treatment of spinal cord compression and is associated with less long-term skeletal sequelae than the two other modalities (Plantaz et al. 1996; Hoover et al. 1999; Katzenstein et al. 2001).

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