Bilateral globus pallidus internus deep brain stimulation for dyskinetic cerebral palsy supports success of cochlear implantation in a 5-year old ex-24 week preterm twin with absent cerebellar hemispheres

被引:8
作者
Lin, Jean-Pierre [1 ]
Kaminska, Margaret [1 ]
Perides, Sarah [1 ]
Gimeno, Hortensia [1 ]
Baker, Lesley [1 ]
Lumsden, Daniel E. [1 ]
Britz, Anzell [2 ]
Driver, Sandra [2 ]
Fitzgerald-O'Connor, Alec [2 ]
Selway, Richard [3 ]
机构
[1] Guys & St Thomas NHS Fdn Trust, Evelina London Childrens Hosp, St Thomas Hosp, Complex Motor Disorders Serv, London, ON, Canada
[2] Guys & St Thomas NHS Fdn Trust, St Thomas Hosp, Dept Audiol, London, England
[3] Kings Coll Hosp NHS Fdn Trust, Dept Neurosurg, Denmark Hill, London SE5 9RS, England
基金
美国国家卫生研究院;
关键词
Dystonic cerebral palsy; Deafness; Deep brain stimulation; Cochlear implantation; Neuromodulation; Childhood; FAHN-MARSDEN DYSTONIA; SECONDARY DYSTONIA; CHILDHOOD DYSTONIA; MOVEMENT-DISORDERS; YOUNG-PEOPLE; CHILDREN; LIFE; NEURODEGENERATION; SEVERITY; MOTOR;
D O I
10.1016/j.ejpn.2016.11.017
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: Early onset dystonia (dysldnesia) and deafness in childhood pose significant challenges for children and carers and are the cause of multiple disability. It is particularly tragic when the child cannot make use of early cochlear implantation (CI) technology to relieve deafness and improve language and communication, because severe cervical and truncal dystonia brushes off the magnetic amplifier behind the ears. Bilateral globus pal lidus internus (GPi) deep brain stimulation (DBS) neuromodulation can reduce dyskinesia, thus supporting CI neuromodulation success. Methods: We describe the importance of the order of dual neuromodulation surgery for dystonia and deafness. First with bilateral GPi DBS using a rechargeable ACTIVA-RC neurostimulator followed 5 months later by unilateral CI with a Harmony (BTE) Advanced Bionics Hi Res 90 K cochlear device. This double neuromodulation was performed in series in a 12.5 kg 5 year-old ex-24 week gestation-born twin without a cerebellum. Results: Relief of dyskinesia enabled continuous use of the CI amplifier. Language understanding and communication improved. Dystonic storms abated. Tolerance of sitting increased with emergence of manual function. Status dystonicus ensued 10 days after ACTIVA-RC removal for infection-erosion at 3 years and 10 months. He required intensive care and DBS re-implantation 3 weeks later together with 8 months of hospital care. Today he is virtually back to the level of functioning before the DBS removal in 2012 and background medication continues to be slowly weaned. Conclusion: This case illustrates that early neuromodulation with DBS for dystonic cerebral palsy followed by CI for deafness is beneficial. Both should be considered early i.e. under the age of five years. The DBS should precede the CI to maximise dystonia reduction and thus benefits from CI. This requires close working between the paediatric DBS and CI services. (C) 2016 Published by Elsevier Ltd on behalf of European Paediatric Neurology Society.
引用
收藏
页码:202 / 213
页数:12
相关论文
共 41 条
[21]   The impact and prognosis for dystonia in childhood including dystonic cerebral palsy: a clinical and demographic tertiary cohort study [J].
Lin, Jean-Pierre ;
Lumsden, Daniel E. ;
Gimeno, Hortensia ;
Kaminska, Margaret .
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 2014, 85 (11) :1239-1244
[22]   Observation and Modeling of Deep Brain Stimulation Electrode Depth in the Pallidal Target of the Developing Brain [J].
Lumsden, Daniel E. ;
Ashmore, Jonathan ;
Charles-Edwards, Geoffrey ;
Selway, Richard ;
Lin, Jean-Pierre ;
Ashkan, Keyoumars .
WORLD NEUROSURGERY, 2015, 83 (04) :438-446
[23]   Interventional studies in childhood dystonia do not address the concerns of children and their carers [J].
Lumsden, Daniel E. ;
Gimeno, Hortensia ;
Tustin, Kylee ;
Kaminska, Margaret ;
Lin, Jean-Pierre .
EUROPEAN JOURNAL OF PAEDIATRIC NEUROLOGY, 2015, 19 (03) :327-336
[24]   Dystonia Severity Action Plan: a simple grading system for medical severity of status dystonicus and life-threatening dystonia [J].
Lumsden, Daniel E. ;
Lundy, Claire ;
Fairhurst, Charlie ;
Lin, Jean-Pierre .
DEVELOPMENTAL MEDICINE AND CHILD NEUROLOGY, 2013, 55 (07) :671-672
[25]   Proportion of life lived with dystonia inversely correlates with response to pallidal deep brain stimulation in both primary and secondary childhood dystonia [J].
Lumsden, Daniel E. ;
Kaminska, Margaret ;
Gimeno, Hortensia ;
Tustin, Kylee ;
Baker, Lesley ;
Perides, Sarah ;
Ashkan, Keyoumars ;
Selway, Richard ;
Lin, Jean-Pierre .
DEVELOPMENTAL MEDICINE AND CHILD NEUROLOGY, 2013, 55 (06) :567-574
[26]   Accuracy of stimulating electrode placement in paediatric pallidal deep brain stimulation for primary and secondary dystonia [J].
Lumsden, Daniel E. ;
Ashmore, Jonathan ;
Charles-Edwards, Geoff ;
Lin, Jean-Pierre ;
Ashkan, Keyoumars ;
Selway, Richard .
ACTA NEUROCHIRURGICA, 2013, 155 (05) :823-836
[27]   Battery life following pallidal deep brain stimulation (DBS) in children and young people with severe primary and secondary dystonia [J].
Lumsden, Daniel E. ;
Kaminska, Margaret ;
Tustin, Kylie ;
Gimeno, Hortensia ;
Baker, Lesley ;
Ashkan, Keyoumars ;
Selway, Richard ;
Lin, Jean-Pierre .
CHILDS NERVOUS SYSTEM, 2012, 28 (07) :1091-1097
[28]   PEDiDBS: The pediatric international deep brain stimulation registry project [J].
Marks, Warren ;
Bailey, Laurie ;
Sanger, Terence D. .
EUROPEAN JOURNAL OF PAEDIATRIC NEUROLOGY, 2017, 21 (01) :218-222
[29]   Dystonia Due to Cerebral Palsy Responds to Deep Brain Stimulation of the Globus Pallidus Internus [J].
Marks, Warren A. ;
Honeycutt, John ;
Acosta, Fernando, Jr. ;
Reed, MaryAnn ;
Bailey, Laurie ;
Pomykal, Angela ;
Mercer, Mary .
MOVEMENT DISORDERS, 2011, 26 (09) :1748-1751
[30]   Central motor conduction studies and diagnostic magnetic resonance imaging in children with severe primary and secondary dystonia [J].
Mcclelland, Verity ;
Mills, Kerry ;
Siddiqui, Ata ;
Selway, Richard ;
Lin, Jean-Pierre .
DEVELOPMENTAL MEDICINE AND CHILD NEUROLOGY, 2011, 53 (08) :757-763