Opsoclonus Myoclonus Syndrome/Dancing Eye Syndrome (OMS/DES) in Children With and Without Neuroblastoma (NBpos and NBneg)Opsoclonus Myoclonus Syndrome/Dancing Eye Syndrome (OMS/DES) in Children With and Without Neuroblastoma (NBpos and NBneg)

Prior treatment

• prior or parallel use of chemotherapy (other than required for treatment of the neuroblastoma)
• Corticoid steroid for OMS/DES or other reasons lasting 14 days or more immediately before treatment start according the standard treatment proposed (treatment with corticosteroids for less than 14 days will be allowed)
• contre-indication of use of one of the experimental study drug (cf Summary of Product Characteristics used in this study)

Other illness

• •Patients with opsoclonus, myoclonus or ataxia caused by other identified disease (e.g. current active CNS infection, neurometabolic disorder or demyelination).

Other

• An identified viral precursor is not an exclusion criterion.

• Children with newly diagnosed OMS/DES either NB-pos or NB-neg.
  • Three out of the following four components are necessary for the diagnosis of OMS/DES:
• Opsoclonus or ocular flutter (but not nystagmus)
• Ataxia and/or myoclonus
• Behavioural change and/or sleep disturbance
• Neuroblastoma The diagnosis of OMS/DES may be difficult in some patients. Opsoclonus, in particular, may be intermittent or late in onset. A video example will be available at www.dancingeyes.org.uk. If uncertain, please contact the national coordinator for support in interpreting clinical features.
  • Age 6 months or over up to less than 8 years (\< 8th birthday) The date of diagnosis of OMS/DES is the date on which a doctor confirms the condition to be OMS/DES. The date of symptom onset needs also to be documented.
  • Treatment start with the standard corticosteroid treatment with dexamethasone pulses as proposed by the guidelines given in this trial protocol (see 11.10, page 71).
  • In patients with presumed NB-neg OMS/DES, neuroblastoma must be excluded according the guidelines of this trial (see chapter 4.4.1.4, page 30, and appendix 11.9, page 70)
  • Documented informed consent for treatment and enrolment in the trial by parents / legal representatives.