Incidence and prognostic factors of ataxia in children with posterior fossa tumors.
ataxia
pediatrics
posterior fossa tumor
Journal
Neuro-oncology practice
ISSN: 2054-2577
Titre abrégé: Neurooncol Pract
Pays: England
ID NLM: 101640528
Informations de publication
Date de publication:
May 2019
May 2019
Historique:
entrez:
7
8
2019
pubmed:
7
8
2019
medline:
7
8
2019
Statut:
ppublish
Résumé
There is minimal literature specific to motor outcomes in children with posterior fossa tumors (PFTs) despite ataxia being a significant problem in this group. This study aims to report children's physical outcomes following management of PFT and determine which factors affect severity of ataxia and functional limitations. Forty-two children aged between 5 and 17 and between 1 and 4 years following surgery for PFT were assessed using the Scale for the Assessment and Rating of Ataxia (SARA), the Brief Ataxia Rating Scale (BARS), and the mobility Pediatric Evaluation of Disability Inventory (PEDI) subscale to determine prevalence and severity of ataxia and a measure of physical function. Analysis was undertaken comparing impact of tumor location, tumor histology, adjuvant treatment, age at diagnosis, presence of preoperative ataxia, and presence of cerebellar mutism syndrome (CMS) on ataxia and physical function scores. Seventy-one percent of children demonstrated a SARA and BARS score greater than 2. A total of 48% of children had a PEDI-m score greater than 90. There was no correlation between age at diagnosis or preoperative ataxia and assessment scores. There was a significant difference in SARA/BARS and PEDI-mobility scores depending on tumor histology, tumor location, and presence of CMS. A high proportion of children (>1 year) following surgery for PFT continue to present with ataxia. Higher ataxia and lower physical function scores were demonstrated in children with medulloblastoma and midline tumors and those diagnosed with CMS. The high prevalence of ataxia demonstrates the need for further research regarding rehabilitation management in this population.
Sections du résumé
BACKGROUND
BACKGROUND
There is minimal literature specific to motor outcomes in children with posterior fossa tumors (PFTs) despite ataxia being a significant problem in this group. This study aims to report children's physical outcomes following management of PFT and determine which factors affect severity of ataxia and functional limitations.
METHODS
METHODS
Forty-two children aged between 5 and 17 and between 1 and 4 years following surgery for PFT were assessed using the Scale for the Assessment and Rating of Ataxia (SARA), the Brief Ataxia Rating Scale (BARS), and the mobility Pediatric Evaluation of Disability Inventory (PEDI) subscale to determine prevalence and severity of ataxia and a measure of physical function. Analysis was undertaken comparing impact of tumor location, tumor histology, adjuvant treatment, age at diagnosis, presence of preoperative ataxia, and presence of cerebellar mutism syndrome (CMS) on ataxia and physical function scores.
RESULTS
RESULTS
Seventy-one percent of children demonstrated a SARA and BARS score greater than 2. A total of 48% of children had a PEDI-m score greater than 90. There was no correlation between age at diagnosis or preoperative ataxia and assessment scores. There was a significant difference in SARA/BARS and PEDI-mobility scores depending on tumor histology, tumor location, and presence of CMS.
CONCLUSIONS
CONCLUSIONS
A high proportion of children (>1 year) following surgery for PFT continue to present with ataxia. Higher ataxia and lower physical function scores were demonstrated in children with medulloblastoma and midline tumors and those diagnosed with CMS. The high prevalence of ataxia demonstrates the need for further research regarding rehabilitation management in this population.
Identifiants
pubmed: 31386000
doi: 10.1093/nop/npy033
pii: npy033
pmc: PMC6656303
doi:
Types de publication
Journal Article
Langues
eng
Pagination
185-193Références
Pediatr Neurosurg. 1999 Sep;31(3):131-6
pubmed: 10708354
Neurosurgery. 2000 Oct;47(4):879-85; discussion 885-7
pubmed: 11014428
Childs Nerv Syst. 2001 Sep;17(9):503-11
pubmed: 11585322
J Clin Oncol. 2003 Apr 1;21(7):1347-51
pubmed: 12663725
J Clin Oncol. 2004 Mar 15;22(6):999-1006
pubmed: 15020603
Neurosurgery. 2004 Mar;54(3):553-63; discussion 563-5
pubmed: 15028128
Phys Occup Ther Pediatr. 2004;24(3):61-77
pubmed: 15257969
Phys Ther. 2005 Aug;85(8):782-90
pubmed: 16048425
J Clin Oncol. 2005 Aug 20;23(24):5511-9
pubmed: 16110011
Ann Intern Med. 2005 Nov 1;143(9):639-47
pubmed: 16263886
Neurology. 2006 Jun 13;66(11):1717-20
pubmed: 16769946
J Neurosurg. 2006 Dec;105(6 Suppl):444-51
pubmed: 17184075
Neurosci Biobehav Rev. 2007;31(8):1101-13
pubmed: 17599406
J Clin Oncol. 2007 Sep 20;25(27):4239-45
pubmed: 17878477
J Neurol Sci. 2008 Mar 15;266(1-2):164-6
pubmed: 17950753
Neuropsychology. 2008 Mar;22(2):159-68
pubmed: 18331158
Childs Nerv Syst. 2008 Sep;24(9):995-1002; discussion 1003
pubmed: 18581121
Pediatr Blood Cancer. 2009 Sep;53(3):424-31
pubmed: 19484752
Mov Disord. 2009 Sep 15;24(12):1820-8
pubmed: 19562773
Neurology. 2009 Dec 1;73(22):1823-30
pubmed: 19864636
Psychiatry (Edgmont). 2007 Jul;4(7):28-37
pubmed: 20526405
Childs Nerv Syst. 2010 Sep;26(9):1173-88
pubmed: 20552208
Childs Nerv Syst. 2011 Mar;27(3):355-63
pubmed: 21061011
Pediatr Blood Cancer. 2011 Mar;56(3):361-7
pubmed: 21225912
Brain Lang. 2013 Dec;127(3):327-33
pubmed: 23398780
Med Pediatr Oncol. 1990;18(4):304-10
pubmed: 2355890
J Neurol. 2014 Feb;261(2):251-8
pubmed: 23589192
Neuro Oncol. 2014 Jan;16(1):147-55
pubmed: 24305707
Dev Med Child Neurol. 2014 Jun;56(6):556-63
pubmed: 24392880
Childs Nerv Syst. 2015 May;31(5):693-7
pubmed: 25735848
Neurooncol Pract. 2014 Sep;1(3):114-122
pubmed: 26034623
Childs Nerv Syst. 2016 Jul;32(7):1195-203
pubmed: 27142103
Dev Med Child Neurol. 2017 Oct;59(10):1077-1082
pubmed: 28815574
Br J Neurosurg. 2018 Feb;32(1):18-27
pubmed: 29433337
Cancer. 1984 Jul 1;54(1):135-8
pubmed: 6722738