The utilization of the multimodal immunotherapy for the opsoclonus–myoclonus syndrome can reduce relapses and permanent neurological sequelae

Table 1 Demographic and basic clinical information of the patients

Clinical feature	Patient 1	Patient 2	Patient 3	Patient 4	Patient 5	Patient 6
Age of onset	16 months	15 months	14 months	9 months	18 months	16 months
Sex	Female	Male	Female	Female	Male	Male
Clinical manifestations
Opsoclonus	Yes	Yes	Yes	Yes	Yes	Yes
Myoclonus	Yes	Yes	Yes	Yes	Yes	Yes
Ataxia	Yes	Yes	Yes	Yes	Yes	Yes
Irritability	Yes	Yes	Yes	Yes	Yes	Yes
Sleep disturbance	Yes	Yes	Yes	Yes	Yes	Yes
Abnormal behavior	Yes	Yes	Yes	Yes	Yes	Yes
Feeling frightened	Yes	No	No	No	Yes	Yes
Preceding manifestations	None	Vaccination of varicella	None	None	None	None
Etiology (neuroblastoma or infectious)	Unknown	Unknown	Neuroblastoma	Unknown	Unknown	Neuroblastoma
OMS score at presentation	18	18	15	18	14	14
Investigations
Evidence of pathogenic infection after screening	No	No	No	No	No	No
CSF analysis (antibodies)	Not available	Negative	Not available	Not available	Negative	Negative
Serum analysis (antibodies)	Negative	Negative	Not available	Negative	Negative	Negative
Neuron-specific enolase	Elevated	Elevated	Elevated	Elevated	Elevated	Elevated
Electroencephalograph	Normal at the beginning, slow background later.	Normal at the beginning, slow background later.	Slow background	Slow background then normal.	Normal	Normal
Targeted/whole-body MRI/CT for neuroblastoma	Normal	Normal	CT found neuroblastoma in the posterior mediastinum.	Normal	Normal	CT found neuroblastoma in the posterior mediastinum
Urine catecholamine (Vanillylmandelic acid )	Negative	Negative	Not available	Elevated	Negative	Negative

Abbreviations: CSF; cerebral spinal fluid, CT; computed tomography, MRI; magnetic resonance imaging, OMS; Opsoclonus–myoclonus syndrome

ISSN: 1824-7288