Department of Neurology, Cook Children's Medical Center, Fort Worth, Texas 76104, USA.
Mov Disord. 2011 Aug 1;26(9):1748-51. doi: 10.1002/mds.23723. Epub 2011 Apr 12.
Cerebral palsy is the most common cause of pediatric-onset dystonia. Deep brain stimulation is gaining acceptance for treating dystonias in children. There is minimal reported experience regarding the efficacy of deep brain stimulation in cerebral palsy.
Fourteen patients, including 8 younger than 16 years, received bilateral implants (13 patients) or a unilateral implant (1 patient) of the internal globus pallidus and were observed in a noncontrolled, nonblinded study for at least 6 months. Motor function was assessed using the Burke-Fahn-Marsden Dystonia Movement and Disability scales and the Barry Albright Dystonia Scale.
By 6 months, significant improvement was observed in the Burke-Fahn-Marsden Dystonia Movement scale (P=.004), the Burke-Fahn-Marsden Dystonia Disability scale (P=.027), and the Barry Albright Dystonia Scale (P=.029) for the whole cohort (n=14) and in the patients treated before skeletal maturity (group 1; n=8): Burke-Fahn-Marsden Dystonia Movement scale, P=.012; Burke-Fahn-Marsden Dystonia Disability scale, P=.020; and Barry Albright Dystonia Scale, P=.027.
Deep brain stimulation may offer an effective treatment option for cerebral palsy-related dystonia, especially in those treated before skeletal maturity.
脑瘫是儿童发病性肌张力障碍的最常见原因。深部脑刺激术在治疗儿童肌张力障碍方面正逐渐得到认可。关于深部脑刺激术治疗脑瘫的疗效，报告的经验很少。
14 名患者（包括 8 名年龄小于 16 岁的患者）接受了双侧内苍白球植入（13 例）或单侧植入（1 例），并在非对照、非盲研究中至少观察 6 个月。运动功能使用 Burke-Fahn-Marsden 肌张力障碍运动和残疾量表以及 Barry Albright 肌张力障碍量表进行评估。
在 6 个月时，整个队列（n=14）和在骨骼成熟前接受治疗的患者（第 1 组，n=8）的 Burke-Fahn-Marsden 肌张力障碍运动量表（P=.004）、Burke-Fahn-Marsden 肌张力障碍残疾量表（P=.027）和 Barry Albright 肌张力障碍量表（P=.029）均有显著改善。
深部脑刺激术可能为脑瘫相关肌张力障碍提供一种有效的治疗选择，尤其是在骨骼成熟前接受治疗的患者。
