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      Stimulation of the globus pallidus internus for childhood-onset dystonia.

      Movement Disorders
      Adolescent, Adult, Age of Onset, Antiparkinson Agents, therapeutic use, Child, Child, Preschool, Deep Brain Stimulation, instrumentation, Dystonia, drug therapy, physiopathology, therapy, Female, Globus Pallidus, Humans, Infant, Levodopa, Male, Questionnaires, Videotape Recording, Walking

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          Abstract

          We report the results of deep brain stimulation (DBS) of the globus pallidus internus (GPi) in 12 patients with childhood-onset generalized dystonia refractory to medication, including 3 patients with status dystonicus. There were 8 patients who had DYT1-negative primary dystonia, 1 had DYT1-positive dystonia, and 3 had symptomatic dystonia. Stimulation was effective in all but 1 patient. Dystonic postures and movements of the axis and limbs responded to DBS to a greater extent than oromandibular dystonia and fixed dystonic postures. These findings provide further evidence that pallidal stimulation is an effective treatment for intractable childhood-onset dystonia, including status dystonicus, and together with previous findings, suggest that it should be considered the treatment of choice for these conditions. (c) 2005 Movement Disorder Society.

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