Paraneoplastic syndromes may affect the central and peripheral nervous system of adults and children with cancer. Neurological symptoms may resolve with treatment of the underlying neoplasm. We report the case of a child with Wilms tumor who presented with generalized weakness, fatigue, ptosis, hypokinesis, dysarthria, urinary retention, facial diplegia, ophthalmoplegia, and autonomic dysfunction. Routine electrodiagnostic testing, including repetitive nerve stimulation, was normal. Clinical features and stimulation single-fiber electromyogram were consistent with a neuromuscular junction transmission disorder, likely Lambert-Eaton myasthenic syndrome. The child’s neurological status returned to normal with successful treatment of the tumor.
*Department of Pediatrics, Division of Pediatric Hematology/Oncology/Blood and Marrow Transplant, Children's Hospital of Wisconsin
†Department of Pediatrics, Division of Pediatric Hematology/Oncology/Blood and Marrow Transplant
‡Department of Pediatrics, Division of Neurology
§Department of Medicine, Division of Neurology, Medical College of Wisconsin, Milwaukee, WI
The authors declare no conflict of interest.
Reprints: Michael E. Kelly, MD, PhD, Department of Pediatrics, Division of Pediatric Hematology/Oncology/Blood and Marrow Transplant, Medical College of Wisconsin; Medical College of Wisconsin, 8701 Watertown Plank Road, MFRC 3018, Milwaukee, WI 53226 (e-mail: firstname.lastname@example.org).
Received March 14, 2012
Accepted February 13, 2013