Child's Nervous System

, Volume 28, Issue 10, pp 1701–1714

Pediatric indications for deep brain stimulation

  • Matthew F. DiFrancesco
  • Casey H. Halpern
  • Howard H. Hurtig
  • Gordon H. Baltuch
  • Gregory G. Heuer
Review Paper

DOI: 10.1007/s00381-012-1861-2

Cite this article as:
DiFrancesco, M.F., Halpern, C.H., Hurtig, H.H. et al. Childs Nerv Syst (2012) 28: 1701. doi:10.1007/s00381-012-1861-2

Abstract

Purpose

Based on the success of deep brain stimulation (DBS) in the treatment of adult disorders, it is reasonable to assume that the application of DBS in the pediatric population is an emerging area worthy of study. The purpose of this paper is to outline the current movement disorder indications for DBS in the pediatric population, and to describe areas of investigation, including possible medically refractory psychiatric indications.

Methods

We performed a structured review of the English language literature from 1990 to 2011 related to studies of DBS in pediatrics using Medline and PubMed search results.

Results

Twenty-four reports of DBS in the pediatric population were found. Based on published data on the use of DBS for pediatric indications, there is a spectrum of clinical evidence for the use of DBS to treat different disorders. Dystonia, a disease associated with a low rate of remission and significant disability, is routinely treated with DBS and is currently the most promising pediatric application of DBS. We caution the application of DBS to conditions associated with a high remission rate later in adulthood, like obsessive-compulsive disorder and Tourette’s syndrome. Moreover, epilepsy and obesity are currently being investigated as indications for DBS in the adult population; however, both are associated with significant morbidity in pediatrics.

Conclusion

While currently dystonia is the most promising application of DBS in the pediatric population, multiple conditions currently being investigated in adults also afflict children and adolescents, and thus warrant further research.

Keywords

Deep brain stimulation Pediatric Dystonia Obsessive-compulsive disorder Tourette’s syndrome Epilepsy Juvenile parkinsonism Obesity 

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Matthew F. DiFrancesco
    • 1
  • Casey H. Halpern
    • 1
  • Howard H. Hurtig
    • 2
  • Gordon H. Baltuch
    • 1
  • Gregory G. Heuer
    • 3
  1. 1.Center for Functional and Restorative Neurosurgery, Department of NeurosurgeryUniversity of PennsylvaniaPhiladelphiaUSA
  2. 2.Center for Functional and Restorative Neurosurgery, Department of NeurologyUniversity of PennsylvaniaPhiladelphiaUSA
  3. 3.Division of Neurosurgery, One Children’s CenterChildren’s Hospital of PhiladelphiaPhiladelphiaUSA

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