Session Information
Date: Thursday, June 8, 2017
Session Title: Dystonia
Session Time: 1:15pm-2:45pm
Location: Exhibit Hall C
Objective: To present 5 children with Gpi and VL thalamus Deep-Brain Stimulation for treatment of secondary dystonia.
Background: The target for deep brain stimulation (DBS) in children with primary dystonia is commonly the internal Globus Pallidus (GPi). The target of DBS in children with secondary dystonia is not known. We report on the clinical evaluation of five children with combined GPi and VL thalamus DBS for generalized or hemi dystonia.
Methods: Findings of five children with combined GPi and VL stimulation is observed by switching VL stimulation on and off. We observe that the effect of adding VL stimulation is immediate and positive. Video recordings were rated using the Barry-Albright Dystonia rating scale (BAD). Parents rated improvement using a 6-point scale. Children age 11-20 were followed for up to 12 Months after implant. Diagnoses included: Traumatic brain injury at 4 months of age, dyskinetic cerebral palsy, near drowning at 19 months of age, and dopamine transporter deficiency,
Results: Functional improvements included newfound ability to play adapted sports (1 child), increased weight bearing during supported ambulation (1 child), decreased hyperkinetic movements (all children), improved reaching (3 children), improved relaxation of limbs (1 child). An immediate effect of VL stimulation was noted within seconds of initial stimulation. Effects of VL stimulation were additive to those of Gpi. VL stimulation did not substitute for Gpi stimulation, and withdrawal of Gpi stimulation caused worsening hypertonia in all children. Withdrawal of VL stimulation caused worsening of hyperkinetic movements in 4 of the children. No significant difference was found in the BAD rating.
Conclusions: Optimal targeting for DBS in children with secondary dystonia is not known. Gpi and VL thalamus DBS work synergistically. Immediate response can be seen with VL stimulation and improvement is reported subjectively and objectively. GPi stimulation may be more effective at controlling hypertonic components, while VL may be more effective at controlling hyperkinetic components of dystonia suggesting that combined Gpi + VL DBS may be useful for children with secondary dystonia.
To cite this abstract in AMA style:
D. German, T. Sanger. Improvement Observed in Children with combined GPi and VL Thalamus Deep Brain Stimulation for the Treatment of Secondary Dystonia [abstract]. Mov Disord. 2017; 32 (suppl 2). https://www.mdsabstracts.org/abstract/improvement-observed-in-children-with-combined-gpi-and-vl-thalamus-deep-brain-stimulation-for-the-treatment-of-secondary-dystonia/. Accessed June 15, 2025.« Back to 2017 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/improvement-observed-in-children-with-combined-gpi-and-vl-thalamus-deep-brain-stimulation-for-the-treatment-of-secondary-dystonia/