Abstract Details

Title SMART Syndrome (Stroke-Like Migraine Attacks after Radiation Therapy) in Adult and Pediatric Patients

Topic Child Neurology/Developmental Neurobiology

Presentation(s) P03 - (-)

Poster/Presentation
Number 007

Objective

Background BACKGROUND: SMART syndrome (stroke-like migraine attacks after radiation therapy) is a rare condition that involves complex migraines with focal neurologic findings in patients following cranial irradiation for CNS malignancies. Little is known about the mechanisms behind the disorder, making successful treatment challenging.

Design/Methods DESIGN/METHODS: We report 2 new cases of SMART syndrome in pediatric patients as well as review all documented cases of the syndrome. Data from these cases was tabulated and analyzed in conjunction with all existing reports of SMART syndrome to better define the features and epidemiology of the disorder.

Results RESULTS: Each of our 2 pediatric patients suffered multiple episodes of the syndrome involving severe headache, visual disturbance, aphasia, and weakness. Recovery occurred over several days to weeks. The data from all documented reports of SMART syndrome, including these 2 new cases, indicate that male gender may be a risk factor for SMART syndrome. Additionally, an age-dependent pattern is observed, with patients who received cranial irradiation at a younger age developing SMART syndrome sooner.

Conclusions CONCLUSIONS: SMART syndrome appears to be a reversible and recurrent long term complication of cranial irradiation. A review of the data indicates that age and gender may play a role in the development of the disease. Additionally, we postulate other mechanisms of SMART syndrome including possible genetic and hormonal influences.

Authors/Disclosures
Amy Armstrong PRESENTER	No disclosure on file
Francis J. DiMario, Jr., MD (CT Childrens Medical Ctr)	No disclosure on file
Fred D. Lublin, MD, FAAN (Icahn School of Medicine At Mount Sinai)	Dr. Lublin has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Roche/Genentech. Dr. Lublin has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Lublin has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neurogene. Dr. Lublin has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Lublin has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Medimmune/Viela Bio/Horizon. Dr. Lublin has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Receptos/Celgene/BMS. Dr. Lublin has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Immunic. Dr. Lublin has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Labcorp. Dr. Lublin has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Neuralight. Dr. Lublin has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Entelexo. Dr. Lublin has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Janssen. Dr. Lublin has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Avotres. Dr. Lublin has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi. Dr. Lublin has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen. Dr. Lublin has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for EMD Serono. Dr. Lublin has received personal compensation in the range of $100,000-$499,999 for serving as an Expert Witness for Multiple entities. Dr. Lublin has stock in Avotres. Dr. Lublin has stock in Neuralight. The institution of Dr. Lublin has received research support from Brainstorm. The institution of Dr. Lublin has received research support from biogen. The institution of Dr. Lublin has received research support from NIH.

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