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Text
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Citation List Month
March 2017 List
Dublin Core
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Title
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Historical Developments In Children's Deep Brain Stimulation
Publisher
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European Journal Of Paediatric Neurology
Date
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2017
Subject
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Brain Depth Stimulation; Dystonia; Pediatrics; Adult; Basal Ganglion; Central Nervous System; Child; Clinical Feature; Clinical Outcome; Clinical Study; Degenerative Disease; Dystonia/su [surgery]; Dystonic Disorder/su [surgery]; Globus Pallidus; Human; Medical History; Myoclonus; Myoclonus Dystonia/su [surgery]; Nerve Cell Network; Nerve Conduction; Neuromodulation; Palliative Therapy; Priority Journal; Review; Side Effect; Subthalamic Nucleus; Surgery; Symptom; Thalamus; Thalamus Nucleus
Creator
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Cif L; Coubes P
Description
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Background Heterogeneous by the underlying pathobiology and clinical presentation, childhood onset dystonia is most frequently progressive, with related disability and limitations in functions of daily living. Consequently, there is an obvious need for efficient symptomatic therapies. Methods and Results Following lesional surgery to basal ganglia (BG) and thalamus, deep brain stimulation (DBS) is a more conservative and adjustable intervention to and validated for internal segment of the globus pallidus (GPi), highly efficient in treating isolated "primary" dystonia and associated symptoms such as subcortical myoclonus. The role of DBS in acquired, neurometabolic and degenerative disorders with dystonia deserves further exploration to confirm as an efficient and lasting therapy. However, the pathobiological background with distribution of the sequellae over the central nervous system and related clinical features, will limit DBS efficacy in these conditions. Cumulative arguments propose DBS in severe life threatening dystonic conditions called status dystonicus as first line therapy, irrespective of the underlying cause. There are no currently available validated selection criteria for DBS in pediatric dystonia. Concurrent targets such as subthalamic nucleus (STN) and several motor nuclei of the thalamus are under exploration and only little information is available in children. DBS programming in paediatric population was adopted from experience in adults. The choice of neuromodulatory DBS parameters could influence not only the initial therapeutic outcome of dystonic symptoms but also its maintenance over time and potentially the occurrence of DBS related side effects. Conclusion DBS allows efficient symptomatic treatment of severe dystonia in children and advances pathophysiological knowledge about local and distributed abnormal neural activity over the motor cortical-subcortical networks in dystonia and other movement disorders. Copyright © 2016 The Authors
Identifier
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10.1016/j.ejpn.2016.08.010
Rights
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2017
Adult
Basal Ganglion
Brain Depth Stimulation
Central Nervous System
Child
Cif L
Clinical Feature
Clinical Outcome
Clinical Study
Coubes P
Degenerative Disease
Dystonia
Dystonia/su [surgery]
Dystonic Disorder/su [surgery]
European Journal of Paediatric Neurology
Globus Pallidus
Human
March 2017 List
Medical History
Myoclonus
Myoclonus Dystonia/su [surgery]
Nerve Cell Network
Nerve Conduction
Neuromodulation
Palliative Therapy
Pediatrics
Priority Journal
Review
Side Effect
Subthalamic Nucleus
Surgery
Symptom
Thalamus
Thalamus Nucleus