Journal
EUROPEAN JOURNAL OF PAEDIATRIC NEUROLOGY
Volume 21, Issue 1, Pages 176-184Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.ejpn.2016.10.002
Keywords
Dystonia; Childhood; Basal ganglia; Electrode; Deep brain stimulation
Categories
Funding
- Guys and St Thomas' Charity New Services and Innovation Grant [G060708]
- Dystonia Society (UK) [01/2011, 09/2013]
- Action Medical Research [GN2097]
- Medtronic
Ask authors/readers for more resources
Deep brain stimulation (DBS) has become a mainstay of dystonia management in adult-hood. Typically targeting electrode placement in the GPi, sustained improvement in dystonic symptoms are anticipated in adults with isolated genetic dystonias. Dystonia in childhood is more commonly a symptomatic condition, with dystonia frequently expressed on the background of a structurally abnormal brain. Outcomes following DBS in this setting are much more variable, the reasons for which have yet to be elucidated. Much of the focus on improving outcomes following DBS in dystonia management has been on the importance of patient selection, with, until recently, little discussion of the choice of target. In this review, we advance the argument that patient selection for DBS in childhood cannot be made separate from the choice of target nuclei. The anatomy of common DBS targets is considered, and factors influencing their choice for electrode insertion are discussed. We propose an ABC for DBS in childhood dystonia is proposed: Appropriate Child selected; Best nuclei chosen for electrode insertion; Correct position within that nucleus. (C) 2016 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available