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(noo″rō-ar-throp′ă-thē, nū″) [neuro- + arthropathy] Disease of a joint associated with disease of the central nervous system.

diabetic n. Charcot foot.


(nū″rō-ăs″trō-sī-tō′mă) [″ + kytos, cell, + oma, tumor] A tumor of the central nervous system composed of neurons and glial cells.


(noor″ō-og-mĕn-tā′shŏn) [neuro- + augmentation] Any method used to increase the function of a nerve, esp. in managing pain. One method is transcutaneous electrical nerve stimulation.


(nū″rō-bī-ŏl′ō-jē) [″ + bios, life, + logos, word, reason] Biology of the nervous system.


(noor′ŏ-blast″) [neuro- + -blast] An embryonic cell that is derived from the neural tube or neural crest and gives rise to a neuron.


(noor″ō-blas-tō′mă) [neuroblast + -oma] A malignant tumor that arises in neuroendocrine cells of the sympathetic nervous system.

INCIDENCE: The disease occurs in about 1 in 100,000 children, usually under the age of 2, and almost always under the age of 5. It is more often diagnosed in boys than in girls.

CAUSES: Neuroblastoma typically develops in cells in the adrenal glands or in cells near the spinal cord or other cells that originate in the embryonic neural crest. The disease sometimes occurs in families. It often arises as a spontaneous mutation in a specific lymphoma kinase.

SYMPTOMS AND SIGNS: Nonspecific symptoms, such as fever, abdominal swelling, loss of appetite, malaise, pain, excessive sweating, tachycardia, and weight loss are characteristic of neuroblastoma. When the disease metastasizes, it may cause symptoms in the organs it invades, e.g., bone pain when it spreads to the skeleton; cough or shortness of breath if it spreads to the lungs; weakness or paralysis if it spreads to nerves or the spinal cord. An unusual feature of neuroblastoma and a small number of other tumors is the paraneoplastic opsoclonus-myoclonus-ataxia syndrome, in which children affected by the tumor have involuntary jerking movements of the limbs, the trunk, and the eyes. SEE: opsoclonus-myoclonus syndrome.

DIAGNOSIS: Neuroblastomas release catecholamines into the blood. Elevated dopamine, homovanillic acid, or vanillylmandelic acid suggest the diagnosis. Imaging studies with metaiodobenzylguanidine (MIBG) can identify tumors like neuroblastoma. Microscopic examination of a biopsy specimen confirms the tumor type as well as its aggressiveness (characterized by its mitosis-karyorrhexis index, the number of active mitoses in tumor cells, and the degree to which the tumor cell nuclei are disintegrating). Chromosomal duplications or duplications of segments of chromosomes in tumor cells can be used to identify tumors that are more or less aggressive.


TREATMENT: A localized neuroblastoma (one ...

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