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Child's Nervous System
Published in: Child's Nervous System 3/2024

25-10-2023 | Dystonia | Original Article

Deep brain stimulation in pediatric dystonia: calls for therapeutic realism over nihilism

Authors: Souvik Singha, Srinivas Dwarakanath, Ravi Yadav, Vikram V. Holla, Nitish Kamble, Gaurav Tyagi, Pramod Kumar Pal

Published in: Child's Nervous System | Issue 3/2024

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Abstract

Purpose

Pediatric dystonia (PD) has a significant negative impact on the growth and development of the child. This study was done retrospectively to analyze functional outcomes in pediatric patients with dystonia who underwent deep brain stimulation.

Methods

In this retrospective analytical study, all the patients of age less than 18 years undergoing deep brain stimulation (DBS) for dystonia between 2012 and 2020 in a single center were analyzed and their functional outcomes were measured by the Burke–Fahn–Marsden-dystonia-rating-scale (BFMDRS).

Results

A total of 10 pediatric patients were included with a mean age of onset, duration of disease, and age at surgery being 5.75 years, 7.36 years, and 13.11 years, respectively, with a mean follow-up of 23.22 months. The mean pre-DBS motor score was 75.44 ± 23.53 which improved significantly at 6-month and 12-month follow-up to 57.27 (p value 0.004) and 50.38 (p value < 0.001), respectively. Limbs sub-scores improved significantly at both the scheduled intervals. There was a significant improvement in disability at 1-year follow-up with significant improvement in feeding, dressing, and walking components. There was a 27.34% and 36.64% improvement in dystonia with a 17.37% and 28.86% reduction in disability at 6 months and 12 months, respectively. There was a positive correlation between the absolute reduction of the motor score and improvement in disability of the patients at 6 months (rho = 0.865, p value 0.003).

Conclusions

DBS in PD has an enormous role in reducing disease burden and achieving a sustainable therapeutic goal.
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Metadata
Title
Deep brain stimulation in pediatric dystonia: calls for therapeutic realism over nihilism
Authors
Souvik Singha
Srinivas Dwarakanath
Ravi Yadav
Vikram V. Holla
Nitish Kamble
Gaurav Tyagi
Pramod Kumar Pal
Publication date
25-10-2023
Publisher
Springer Berlin Heidelberg
Published in
Child's Nervous System / Issue 3/2024
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-023-06182-x

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