Komplikationen des zentralen Nervensystems in der pädiatrischen Onkologie: retrospektive Analyse und klinische Nachuntersuchung überlebender Patienten
Dissertation
Authors
Schmidt, Katrin
Faculties
Medizinische FakultätPeer review
ja
Abstract
Background. Clinical studies analysing CNS complications in pediatric oncology symstematically are rare. Procedure. In a single center retrospective analysis, CNS complications in 950 subsequent pediatric patients treated between 1992 and 2004 by chemotherapy or hematopoietic stem cell transplantation (HSCT) were studied. 46 patients had pre-existing CNS diseases and were excluded. Out of the 904 remaining, 76 (8.4%) had 82 CNS complications. Results. The most common manifestations were seizures (in 50.6% of the CNS episodes), altered states of consciousness, and motor deficits (in 47.5% of the episodes each). CNS complications were caused by infections (26.8%), toxicity (25.6%), neoplasma (13.4%), vascular (10.9%) and metabolic disturbances (8.5%). In 14.6%, the mechanism remained unclear. 23.7% of the patients died from the CNS event. Neoplastic disorders had the worst (50%) while metabolic the best (0% mortality) prognosis. Imaging techniques were the most effective diagnostic measures, followed by laboratory analysis, clinical examination and CSF analysis. A neuro-psychological (CBCL, CFT-1 / -20 – testing) examination could be done in 21 of 32 long-term survivors. 7 had a major, 3 minor neurological impairment, 11 were normal in all tests. Conclusions. These data show that there is not one typical CNS complication, but a wide variety. There is no close connection between either underlying disease or symptoms and cause of the complication. Prognosis is variable. About two thirds of the long-term survivors could lead a normal life.
Date created
2007
Subject Headings
Zentralnervensystem [GND]Central nervous diseases. In infancy and childhood [MeSH]
Neoplasms. In infancy and childhood [MeSH]
Keywords
Neurologische Komplikationen; ZNS-KomplikationenDewey Decimal Group
DDC 610 / Medicine & healthMetadata
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Schmidt, Katrin (2008): Komplikationen des zentralen Nervensystems in der pädiatrischen Onkologie: retrospektive Analyse und klinische Nachuntersuchung überlebender Patienten. Open Access Repositorium der Universität Ulm. Dissertation. http://dx.doi.org/10.18725/OPARU-1360