The combination of high-dose thiotepa and etoposide has activity against a variety of recurrent childhood brain tumors. These results merit further evaluation in children and young adults with both recurrent and newly diagnosed high-grade brain tumors.

Movement disorders from spinal cord disease are rare and can be caused by underlying neoplasm, inflammation, demyelination, or trauma. [1][2][3][4] Cervical radiculopathy caused by disc herniation or cervical spondylosis is common and important to recognize because it may improve after decompression surgery. We describe a patient with cervical disc prolapse presenting with choreoathetosis and dystonia.Case report. A previously well 62-year-old Chinese woman presented with involuntary movements of her upper extremities of 3-month duration. She observed that her fingers would wriggle on their own and her arms would move involuntarily. These movements were much worse during action than rest. She reported no premonition or any urge before these movements, and did not feel any relief afterwards. The movements were aggravated by stress, agitation, or anxiety, and were relieved by rest and sleep. She also noted that her fingers (particularly the index and middle fingers) would intermittently go into spasms, with involuntary flexion at the metacarpal-phalangeal joints; these spasms were relieved by putting her fingers in contact with other body parts. In addition, she had concurrent "tingling" sensations of the fingertips of both hands (right more severely affected). There were no abnormal movements involving the oro-facial-buccal region or lower extremities. She had no urinary or bowel complaints. There was no history of exposure to neuroleptic medications, severe head trauma, or dementia. No relatives had similar problems. She was initially evaluated by an orthopaedic surgeon who suspected underlying carpal tunnel syndrome (CTS). This was confirmed on the nerve conduction test, which revealed a mild to moderately severe right CTS. However, she was subsequently referred to the Movement Disorders Clinic for further evaluation.Neurologic examination demonstrated dystonic posturing of her fingers when upper arms were outstretched and in wingbeating position. Her index and middle fingers were flexed at the metacarpal-phalangeal joints and proximal inter-phalangeal joints, together with mild pronation at the radio-ulnar joints. Stereotypic finger movements were observed when she tried using her hands. On walking, choreoathetoid movements in both of her upper extremities were present. Power in all of her extremities was full. There was increased tone in both her lower extremities, generalized hyper-reflexia in her four extremities with no clonus. Her jaw jerk was not brisk. Plantar response was flexor bilaterally. There was no loss of sensation to pinprick, light touch, or presence of a sensory level, and proprioception and vibration sense were intact. There were no signs of cerebellar dysfunction and Romberg test was negative. She had no clinical evidence of dementia and no Kayser-Fleischer ring on ophthalmic examination.MRI of cervical spine revealed severe cord compression at C3-C4 level by a prolapsed disc ( figure, A and B). Brain MRI scan did not show any abnormalities. Transcranial magnetic stimulation study demonstrat...

The authors propose "decreased-dose-intensity" PCV (procarbazine, lomustine [CCNU], and vincristine) chemotherapy for Asian patients with oligodendroglial tumors. In this study, all seven patients with oligodendroglioma (OD) and eight with anaplastic oligodendroglioma (AO) had objective responses or stable disease. Median progression-free survival was greater than 29 months (OD) and 36.5 months or greater (AO); 86% of patients with OD and 63% with AO remain progression-free. Twenty-four Common Toxicity Criteria Grade 3/4 adverse events were noted.

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