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Child's Nervous System
Published in: Child's Nervous System 4/2017

01-04-2017 | Original Paper

Considerations in deep brain stimulation (DBS) for pediatric secondary dystonia

Authors: Deki Tsering, Laura Tochen, Bennett Lavenstein, Srijaya K. Reddy, Yael Granader, Robert F. Keating, Chima O. Oluigbo

Published in: Child's Nervous System | Issue 4/2017

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Abstract

Purpose

There is a paucity of effective long-term medication treatment for secondary dystonias. In situations where significantly impairing secondary dystonias fail to respond to typical enteral medications and intrathecal (or even intraventricular) baclofen, consideration should be given to the use of deep brain stimulation (DBS). While Level I evidence and long-term follow-up clearly demonstrate the efficacy of DBS for primary dystonia, the evidence for secondary dystonia remains mixed and unclear. In this study, we report our experience with pediatric subjects who have undergone DBS for secondary dystonia.

Methods

We discuss the indications and outcomes of DBS procedures completed at our center. We also present a detailed discussion of the considerations in the management of these patients as well as a literature review.

Results

Of the four cases retrospectively examined here, all subjects experienced reductions in the severity of their dystonia (ranging from 0 to 100% on both the Barry-Albright Dystonia (BAD) and Burke-Fahn-Marsden Dystonia Rating Scale-Motor (BFMDRS-M) scales).

Conclusions

Pallidal DBS should be considered among children with functionally debilitating, medication-resistant secondary dystonia. Patients without fixed skeletal deformities who have experienced a short duration of symptoms are most likely to benefit from this intervention.
Literature
1.
Gil-Robles S, Cif L, Biolsi B, Tancu C, El Fertit H, Coubes P (2006) Neurosurgical treatment in childhood dystonias and dyskinesias. Rev Neurol 43(Suppl 1):S169–S172PubMed
2.
Jani JM, Oluigbo CO, Reddy SK (2015) Anesthesia for deep brain stimulation in traumatic brain injury-induced hemidystonia. Clinical case reports 3:492–495CrossRefPubMedPubMedCentral
3.
Oluigbo CO, Salma A, Rezai AR (2012) Deep brain stimulation for neurological disorders. IEEE Rev Biomed Eng 5:88–99CrossRefPubMed
4.
Cif L, Coubes P (2017) Historical developments in children’s deep brain stimulation. Eur J Paediatr Neurol 21:109–17
5.
Kupsch A, Benecke R, Muller J, Trottenberg T, Schneider GH, Poewe W, Eisner W, Wolters A, Muller JU, Deuschl G, Pinsker MO, Skogseid IM, Roeste GK, Vollmer-Haase J, Brentrup A, Krause M, Tronnier V, Schnitzler A, Voges J, Nikkhah G, Vesper J, Naumann M, Volkmann J (2006) Pallidal deep-brain stimulation in primary generalized or segmental dystonia. N Engl J Med 355:1978–1990CrossRefPubMed
6.
Vidailhet M, Vercueil L, Houeto JL, Krystkowiak P, Benabid AL, Cornu P, Lagrange C, Tezenas du Montcel S, Dormont D, Grand S, Blond S, Detante O, Pillon B, Ardouin C, Agid Y, Destee A, Pollak P (2005) Bilateral deep-brain stimulation of the globus pallidus in primary generalized dystonia. N Engl J Med 352:459–467CrossRefPubMed
7.
Gonzalez V, Le Bars E, Cif L, van Dokkum LE, Laffont I, Bonafe A, Menjot de Champfleur N, Zanca M, Coubes P (2015) The reorganization of motor network in hemidystonia from the perspective of deep brain stimulation. Brain imaging and behavior 9:223–235CrossRefPubMed
8.
Gimeno H, Tustin K, Selway R, Lin JP (2012) Beyond the Burke-Fahn-Marsden dystonia rating scale: deep brain stimulation in childhood secondary dystonia. European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society 16:501–508CrossRef
9.
Marks W, Bailey L, Reed M, Pomykal A, Mercer M, Macomber D, Acosta F Jr, Honeycutt J (2013) Pallidal stimulation in children: comparison between cerebral palsy and DYT1 dystonia. J Child Neurol 28:840–848CrossRefPubMed
10.
Marks WA, Honeycutt J, Acosta F, Reed M (2009) Deep brain stimulation for pediatric movement disorders. Semin Pediatr Neurol 16:90–98CrossRefPubMed
11.
Keen JR, Przekop A, Olaya JE, Zouros A, Hsu FP (2014) Deep brain stimulation for the treatment of childhood dystonic cerebral palsy. J Neurosurg Pediatr 14:585–593CrossRefPubMed
12.
Maldonado IL, Roujeau T, Cif L, Gonzalez V, El-Fertit H, Vasques X, Bonafe A, Coubes P (2009) Magnetic resonance-based deep brain stimulation technique: a series of 478 consecutive implanted electrodes with no perioperative intracerebral hemorrhage. Neurosurgery 65:196–201 discussion -2PubMed
13.
Isaias IU, Alterman RL, Tagliati M (2008) Outcome predictors of pallidal stimulation in patients with primary dystonia: the role of disease duration. Brain : a journal of neurology 131:1895–1902CrossRef
14.
Mehrkens JH, Borggraefe I, Feddersen B, Heinen F, Botzel K (2010) Early globus pallidus internus stimulation in pediatric patients with generalized primary dystonia: long-term efficacy and safety. J Child Neurol 25:1355–1361CrossRefPubMed
15.
Yilmaz S, Turhan T, Ceylaner S, Gokben S, Tekgul H, Serdaroglu G (2016) Excellent response to deep brain stimulation in a young girl with GNAO1-related progressive choreoathetosis. Child’s nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery 32:1567–1568CrossRef
16.
Speelman JD, Contarino MF, Schuurman PR, Tijssen MA, de Bie RM (2010) Deep brain stimulation for dystonia: patient selection and outcomes. Eur J Neurol 17(Suppl 1):102–106CrossRefPubMed
17.
Sayer C, Lumsden DE, Perides S, Tustin K, Bassi S, Lin JP, Kaminska M (2015) Intrathecal baclofen trials: complications and positive yield in a pediatric cohort. Journal of neurosurgery Pediatrics: 1–6
18.
Moro E, Gross RE, Krauss JK (2013) What’s new in surgical treatment for dystonia? Movement disorders : official journal of the Movement Disorder Society 28:1013–1020CrossRef
19.
Saleh C, Gonzalez V, Coubes P (2013) Role of deep brain stimulation in the treatment of secondary dystonia-dyskinesia syndromes. Handb Clin Neurol 116:189–208CrossRefPubMed
20.
Lim BC, Ki CS, Cho A, Hwang H, Kim KJ, Hwang YS, Kim YE, Yun JY, Jeon BS, Lim YH, Paek SH, Chae JH (2012) Pantothenate kinase-associated neurodegeneration in Korea: recurrent R440P mutation in PANK2 and outcome of deep brain stimulation. Eur J Neurol 19:556–561CrossRefPubMed
21.
Sathe KP, Hegde AU, Doshi PK (2013) Deep brain stimulation improves quality of life in pantothenate kinase-associated neurodegeneration. J Pediatr Neurosci 8:46–48CrossRefPubMedPubMedCentral
22.
Lipsman N, Ellis M, Lozano AM (2010) Current and future indications for deep brain stimulation in pediatric populations. Neurosurg Focus 29:E2CrossRefPubMed
23.
Marks WA, Honeycutt J, Acosta F Jr, Reed M, Bailey L, Pomykal A, Mercer M (2011) Dystonia due to cerebral palsy responds to deep brain stimulation of the globus pallidus internus. Movement disorders : official journal of the Movement Disorder Society 26:1748–1751CrossRef
24.
Tierney TS, Lozano AM (2012) Surgical treatment for secondary dystonia. Movement disorders : official journal of the Movement Disorder Society 27:1598–1605CrossRef
25.
Damier P, Thobois S, Witjas T, Cuny E, Derost P, Raoul S, Mertens P, Peragut JC, Lemaire JJ, Burbaud P, Nguyen JM, Llorca PM, Rascol O (2007) Bilateral deep brain stimulation of the globus pallidus to treat tardive dyskinesia. Arch Gen Psychiatry 64:170–176CrossRefPubMed
26.
Marks W, Bailey L, Sanger TD (2017) PEDiDBS: The pediatric international deep brain stimulation registry project. Eur J Paediatr Neurol 21:218–22
Metadata
Title
Considerations in deep brain stimulation (DBS) for pediatric secondary dystonia
Authors
Deki Tsering
Laura Tochen
Bennett Lavenstein
Srijaya K. Reddy
Yael Granader
Robert F. Keating
Chima O. Oluigbo
Publication date
01-04-2017
Publisher
Springer Berlin Heidelberg
Published in
Child's Nervous System / Issue 4/2017
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-017-3361-x

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