RESUMO
We reviewed the neurologic and developmental courses in 10 children with opsoclonus-myoclonus ("dancing eyes syndrome") and neuroblastoma. All patients are alive without evidence of neoplastic disease after 8+ to 111+ months of follow-up. All had localized disease and 50% had extraabdominal tumors. Neuroblastomas of nine children had favorable Shimada histologic characteristics, and all tumors had single copies of the N-myc oncogene. After neuroblastoma resection, all patients had persistent opsoclonus-myoclonus or ataxia that responded to therapy with adrenocorticotropic hormone. Nine children had relapses of neurologic symptoms. Three years after resection, six of seven patients with sufficient follow-up were free of symptoms and had discontinued therapy. However, nine children had chronic neurologic deficits, including cognitive and motor delays, language deficits, and behavioral abnormalities. All six patients in educational programs required special assistance. Five children required physical, occupational, or speech therapy. Long-term developmental and cognitive problems should be anticipated in patients with neuroblastoma who have opsoclonus-myoclonus or ataxia or both, and early intervention should be instituted to try to minimize these deficits.
Assuntos
Hormônio Adrenocorticotrópico/uso terapêutico , Ataxia/tratamento farmacológico , Mioclonia/tratamento farmacológico , Neuroblastoma/cirurgia , Transtornos da Motilidade Ocular/tratamento farmacológico , Neoplasias Abdominais/complicações , Neoplasias Abdominais/patologia , Neoplasias Abdominais/cirurgia , Neoplasias Abdominais/urina , Neoplasias das Glândulas Suprarrenais/complicações , Neoplasias das Glândulas Suprarrenais/patologia , Neoplasias das Glândulas Suprarrenais/cirurgia , Neoplasias das Glândulas Suprarrenais/urina , Ataxia/complicações , Ataxia/metabolismo , Biomarcadores/urina , Pré-Escolar , Deficiências do Desenvolvimento/etiologia , Feminino , Seguimentos , Neoplasias de Cabeça e Pescoço/complicações , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias de Cabeça e Pescoço/cirurgia , Neoplasias de Cabeça e Pescoço/urina , Ácido Homovanílico/urina , Humanos , Lactente , Masculino , Mioclonia/complicações , Mioclonia/metabolismo , Neuroblastoma/complicações , Neuroblastoma/patologia , Neuroblastoma/urina , Transtornos da Motilidade Ocular/complicações , Transtornos da Motilidade Ocular/metabolismo , Proteínas Proto-Oncogênicas c-myc/metabolismo , Recidiva , Neoplasias Torácicas/complicações , Neoplasias Torácicas/patologia , Neoplasias Torácicas/cirurgia , Neoplasias Torácicas/urina , Fatores de Tempo , Resultado do Tratamento , Ácido Vanilmandélico/urinaRESUMO
This study focused its attention on four medicinal plants (Carapa guianensis, Elephantopus scaber, Piper umbellatum, Stachytarpheta cayenensis) used by Caboclo communities on Marajó, the main island of the Amazon delta. In the field, interviews were conducted with Caboclos and the medicinal usages and preparation procedures of the four plants were recorded. In the laboratory, the plant extracts were subjected to bioassays and their crude chemical composition was established. All four plants showed significant bioactivity and the chemical tests confirmed the presence of bioactive compounds. In addition, the results of both the field and laboratory studies corresponded well with those of a literature search. The ethnopharmacological significance of the four plants is discussed.