Abstract Details

Title Deep Brain Stimulation in Children with Cerebral Palsy vs Dyt-1 Progressive Dystonia

Topic Movement Disorders

Presentation(s) S53 - (-)

Poster/Presentation
Number 003

Objective

Background Electrical stimulation of the globus pallidus is an accepted treatment for DYT-1 dystonia. There is limited experience in treating children with cerebral palsy, the most common movement disorder in children.

Design/Methods Patients aged 7-15 years with either Dyt-1 (n=8) or CP (n=10) implanted between September 2007 and January 2011 were evaluated retrospectively using Burke-Fahn-Marsden Motor and Disability scores. Baseline differences between groups were evaluated by independent t-tests. A two-way analysis of variance repeated measures (ANOVA-RM) with disease (CP vs Dyt-1) as a factor was used to evaluate significant changes in dystonia rating scales between baseline and follow-up assessments.

Results Mean age was 10.15 +/- 3.15 years in the Dyt-1 and 11.30 +/- 3.05 years in the CP groups. At baseline, BFM-motor (69.9, 48.03; t(16)=2.80, p=.013) and BFM-disability scores (35.94, 36.19; t(16)=2.92, p=.010) were significantly higher in the CP cohort than the DYT-1 patient group respectively. The degree of motor improvement was higher in the CP group at both 6 months (31% vs. -0.7%) and 12 months (24% vs. 6%), although overall level of motor impairment (t(11.067)=1.91, p=.082) and disability (t(16)=2.98, p=.009) remained higher than in the DYT-1 cohort.

Conclusions DBS offers a viable treatment for selected patients with dystonia related to cerebral palsy. Motor improvement compares favorable to patients with DYT-1 dystonia, and may occur earlier in the course of treatment. Benefits obtained at six months are maintained after a year of stimulation. The more rapid improvement in CP patients may be due to the non-progressive nature of the motor disorder. Patients with Dyt-1 undergo early DBS for ongoing progressive motor deterioration that must be slowed before stabilization and ultimately improvement.

Authors/Disclosures
Warren Marks, MD (Cook Children's Medical Center) PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Fernando Acosta, MD	No disclosure on file
	No disclosure on file

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