J Korean Neurosurg Soc.  2012 Sep;52(3):261-263.

Deep Brain Stimulation of the Globus Pallidus in a 7-Year-Old Girl with DYT1 Generalized Dystonia

• Jin ST
• Lee MK
• Ghang JY
• Jeon SM

Abstract

The experience of pediatric deep brain stimulation (DBS) of the globus pallidus internus (GPi) in the treatment of early-onset DYT1 generalized dystonia is still limited. Here, we report the surgical experience of bilateral GPi-DBS under general anesthesia by using microelectrode recording in a 7-year-old girl with early-onset DYT1 generalized dystonia. Excellent improvement of her dystonia without neurological complications was achieved. This case report demonstrates that GPi-DBS is an effective and safe method for the treatment of medically refractory early-onset DYT1 generalized dystonia in children.

Keyword

Globus pallidus; DYT1; Dystonia; Deep brain stimulation

MeSH Terms

Anesthesia, General
Child
Deep Brain Stimulation
Dystonia
Globus Pallidus
Humans
Microelectrodes

Reference

1. Alterman RL, Tagliati M. Deep brain stimulation for torsion dystonia in children. Childs Nerv Syst. 2007; 23:1033–1040. PMID: 17551738.

2. Augood SJ, Penney JB Jr, Friberg IK, Breakefield XO, Young AB, Ozelius LJ, et al. Expression of the early-onset torsion dystonia gene (DYT1) in human brain. Ann Neurol. 1998; 43:669–673. PMID: 9585364.

3. Constantoyannis C, Berk C, Honey CR, Mendez I, Brownstone RM. Reducing hardware-related complications of deep brain stimulation. Can J Neurol Sci. 2005; 32:194–200. PMID: 16018154.

4. Coubes P, Cif L, El Fertit H, Hemm S, Vayssiere N, Serrat S, et al. Electrical stimulation of the globus pallidus internus in patients with primary generalized dystonia : long-term results. J Neurosurg. 2004; 101:189–194. PMID: 15309907.

5. Dekaban AS. Changes in brain weights during the span of human life : relation of brain weights to body heights and body weights. Ann Neurol. 1978; 4:345–356. PMID: 727739.

6. Gross RE, Mewes K, Ghani G. Bakay RA, editor. Anesthesia for movement disorder surgery. Movement Disorder Surgery. The Essentials. 2008. New York: Stuttgart;p. 70–82.

7. Isaias IU, Alterman RL, Tagliati M. Outcome predictors of pallidal stimulation in patients with primary dystonia : the role of disease duration. Brain. 2008; 131:1895–1902. PMID: 18567622.

8. Jeong SG, Lee MK, Kang JY, Jun SM, Lee WH, Ghang CG. Pallidal deep brain stimulation in primary cervical dystonia with phasic type : clinical outcome and postoperative course. J Korean Neurosurg Soc. 2009; 46:346–350. PMID: 19893724.

9. Marks WA, Honeycutt J, Acosta F, Reed M. Deep brain stimulation for pediatric movement disorders. Semin Pediatr Neurol. 2009; 16:90–98. PMID: 19501337.

10. Pinsker MO, Volkmann J, Falk D, Herzog J, Steigerwald F, Deuschl G, et al. Deep brain stimulation of the internal globus pallidus in dystonia : target localisation under general anaesthesia. Acta Neurochir (Wien). 2009; 151:751–758. PMID: 19468677.

11. Vidailhet M, Vercueil L, Houeto JL, Krystkowiak P, Lagrange C, Yelnik J, et al. Bilateral, pallidal, deep-brain stimulation in primary generalised dystonia : a prospective 3 year follow-up study. Lancet Neurol. 2007; 6:223–229. PMID: 17303528.

12. Zorzi G, Marras C, Nardocci N, Franzini A, Chiapparini L, Maccagnano E, et al. Stimulation of the globus pallidus internus for childhood-onset dystonia. Mov Disord. 2005; 20:1194–1200. PMID: 15895426.