Child's Nervous System

, Volume 34, Issue 9, pp 1771–1776 | Cite as

DBS in pediatric patients: institutional experience

  • Huseyin CanazEmail author
  • Isik Karalok
  • Baris Topcular
  • Mert Agaoglu
  • Zuhal Yapici
  • Sabri Aydin
Original Paper



DBS is initially used for treatment of essential tremor and Parkinson’s disease in adults. In 1996, a child with severe life-threatening dystonia was offered DBS to the internal globus pallidus (GPi) with lasting efficacy at 20 years. Since that time, increasing number of children benefited from DBS.

Patients and methods

We retrospectively evaluated our database of patients who underwent DBS from 2011 to 2017. All patients ≤ 17 years of age at the time of implantation of DBS were included in this series. Subjective Benefit Rating Scale (SBRS), Hoehn Yahr Scale (HYS), Fahn Marsden Rating Scale (FMRS), Clinical Global Impressions Scales (CGI), and Yale Global Tic Severity Scale (YGT) were used to evaluate clinical outcome.


Between May 2014 and October 2017, 11 children underwent DBS procedure in our institution. Six of them were female and five of them were male. Mean age at surgery was 11.8 ± 4.06 years (range 5–17 years). In our series, four patients had primary dystonia (PDY) (36.3%), three patients had secondary dystonia (SDY) (27.2%), two patients had JP (18.1%), and two patients had Tourette Syndrome (TS) (18.1%). Two JP patients underwent bilateral STN DBS while the other nine patients underwent bilateral GPi DBS. SBRS scores were 1.75 ± 0.5 for patients with PDY, 3 ± 0 for patients with JP, 2.5 ± 0.7 for patients with TS, and 2 ± 1 for patients with SDY. Mean FMRS reduction rate was 40.5 for patients with dystonia. Significant improvement was also defined in patients with TS and JP after DBS. None of the patients experienced any intracerebral hemorrhage or other serious adverse neurological effect related to the DBS. Wound complications occurred in two patients.


There are many literatures that support DBS as a treatment option for pediatric patients with medically refractory neurological disorders. DBS has replaced ablative procedures as a treatment of choice not only for adult patients, but also for pediatric patients. Wound-related complications still remain the most common problem in pediatric patients. Development of smaller and more flexible hardware will improve quality of children’s life and minimize wound-related complications in the future.


Deep brain stimulation Dystonia GPi Juvenile parkinsonism STN Tourette syndrome 



anterior commissure


attention-deficit hyperactivity disorder


Clinical Global Impressions Scales


centromedian–parafascicular nuclear complex of the thalamus


cerebral palsy


computerized tomography


deep brain stimulation


Fahn Marsden Rating Scale


internal globus pallidus


Hoehn Yahr Scale


intensive care unit


juvenile parkinsonism


microelectrode recording;


mitochondrial membrane protein-associated neurodegeneration


magnetic resonance imaging


nucleus accumbens


neurodegeneration with brain iron accumulation


obsessive compulsive disorder


posterior commissure


Parkinson’s disease


primary dystonia


primary generalized dystonia


PTEN-induced putative kinase 1


pantothenate-kinase-associated neurodegeneration


Subjective Benefit Rating Scale


secondary dystonia


subthalamic nucleus


Tourette syndrome


Yale Global Tic Severity Scale


Compliance with ethical standards

This study was approved by the institutional review board of Istanbul Bilim University, Istanbul, Turkey.

Conflict of interest

There are no conflicts of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Neurosurgery, Florence Nightingale HospitalIstanbul Bilim UniversityIstanbulTurkey
  2. 2.Department of RadiologyIstanbul Bilim UniversityIstanbulTurkey
  3. 3.Department of NeurologyIstanbul Bilim UniversityIstanbulTurkey
  4. 4.MedtronicIstanbulTurkey
  5. 5.Division of Pediatric Neurology, Department of NeurologyIstanbul UniversityIstanbulTurkey

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