Course/Event Booking

PROGRAMME

Please note that bookings will close from 14.00 on Thursday 18 May 2023.

This lecture will be on Thursday 18 May 2023 at 3.00-4.30pm (UK time):

Dr Ming Lim, Consultant Paediatric Neurologist, Evelina Children`s Hospital, London
OMS Syndrome and updates

Opsoclonus Myoclonus Ataxia Syndrome (OMAS) in children is a distinct clinical syndrome. It is the one of few recognized paraneoplastic neurological syndromes in children with a known association in more than half of affected children with neuroblastoma. Opsoclonus-myoclonus-ataxia syndrome (OMAS) can leave children with significant neurological and long-term cognitive impairment. Although the evidence base for treatment recommendations is limited, emergent data suggests that earlier and more optimal escalation favours better outcomes in a range of neuroinflammatory conditions. Within this construct, 2 approaches are currently used. The first is an upfront approach often termed the “aggressive” approach using multiple agents, typically adrenocorticotropic hormone (ACTH) or corticosteroids, plasmapheresis, IV immunoglobulin, and rituximab or cyclophosphamide. A second is a stepwise approach starting with pulse oral dexamethasone (20 mg/m2/d for 3 consecutive days monthly) and escalating to rituximab or cyclophosphamide for patients who do not respond adequately. A recent international consensus proposing how both these approaches could be integrated would be discussed; alongside exploring management strategies for chronic relapsing children and when pragmatic (sometimes empirical) strategies may be employed to manage the child with chronic symptoms