Mouvements anormaux de l’enfant : nouveautés thérapeutiques

A Stepwise Approach: Decreasing Infection in Deep Brain Stimulation for Childhood Dystonic Cerebral Palsy

Dystonia is a movement disorder characterized by involuntary muscle contractions, which cause twisting movements or abnormal postures. Deep brain stimulation has been used to improve the quality of life for secondary dystonia caused by cerebral palsy. Despite being a viable treatment option for childhood dystonic cerebral palsy, deep brain stimulation is associated with a high rate of infection in children. The authors present a small series of patients with dystonic cerebral palsy who underwent a stepwise approach for bilateral globus pallidus interna deep brain stimulation placement in order to decrease the rate of infection. Four children with dystonic cerebral palsy who underwent a total of 13 surgical procedures (electrode and battery placement) were identified via a retrospective review. There were zero postoperative infections. Using a multistaged surgical plan for pediatric patients with dystonic cerebral palsy undergoing deep brain stimulation may help to reduce the risk of infection.

Scale for evaluation of movement disorders in the first three years of life

Most rating scales to assess movement disorders in children were mainly designed for adult patients, and are limited to a single type of disorder. A new scale for developmental age, the Movement Disorder-Childhood Rating Scale, was recently designed and validated for children and adolescents aged 4-18 years. We introduce a new version of this scale, the Movement Disorder-Childhood Rating Scale 0-3, suitable for application in children aged <4 years. The scale was tested for reliability and consistency in 40 children (aged 0.3-3.6 years) with different types of movement disorders. The results indicate high interrater agreement on each item, and a high degree of internal consistency on several proposed items. The scale can be used to assess and monitor young children with movement disorders during specific treatments.