Current and Future Indications for Deep Brain Stimulation in Pediatric Populations

Nir Lipsman, M.D.; Michael Ellis, M.D.; Andres M. Lozano, M.D., Ph.D., F.R.C.S.C.

Disclosures

Neurosurg Focus. 2010;29(2):e2 

In This Article

Abstract and Introduction

Abstract

Deep brain stimulation (DBS) has proven to be an effective and safe treatment option in patients with various advanced and treatment-refractory conditions. Thus far, most of the experience with DBS has been in the movement disorder literature, and more specifically in the adult population, where its use in conditions such as Parkinson disease has revolutionized management strategies. The pediatric population, however, can also be afflicted by functionally incapacitating neurological conditions that remain refractory despite the clinicians' best efforts. In such cases, DBS offers an additional treatment alternative. In this paper, the authors review their institution's experience with DBS in the pediatric population, and provide an overview of the literature on DBS in children. The authors conclude that DBS in children can and should be considered a valid and effective treatment option, albeit in highly specific and carefully selected cases.

Introduction

Over the past few decades, the introduction of DBS has revolutionized the management of several functional disorders affecting the adult population. Deep brain stimulation currently plays an established role in the management of movement disorders, providing durable symptom relief and improved quality of life with minimal morbidity and side effects. In addition, the role of DBS procedures is currently under investigation in many other neurological and psychiatric disorders previously considered to be beyond the realm of neurosurgery.[4] In spite of such exciting progress, the application of this therapeutic paradigm to functional disorders affecting the pediatric population remains limited. This review summarizes our institutional experience with DBS in children and discusses the current and potential future role of DBS procedures in the multidisciplinary management of pediatric functional disorders.

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