DBS Becomes Therapeutic Solution for More Children with Movement Disorders

Pediatric neurosurgeons at Orlando Health Arnold Palmer Hospital for Children continue to advance deep brain stimulation (DBS) as a therapeutic option for pediatric patients suffering from certain types of movement disorders and epilepsy. During DBS, surgeons implant electrodes into specific areas of the brain to deliver electrical impulses that help modulate abnormal brain activity.

Considered a mainstay in the treatment of certain types of movement disorders and epilepsy in adults, clinical applications of DBS have been significantly underutilized in children. “Despite excellent outcomes, few children who could benefit from DBS are ever evaluated at centers with the expertise to provide it as an option,” says Ryan Jafrani, MD. He is a dual fellowship-trained pediatric and functional neurosurgeon at the Leon Pediatric Neuroscience Center of Excellence at Orlando Health Arnold Palmer, one of only a few children's hospitals in the country to have an in-house pediatric deep brain stimulation program.

“Children with genetic forms of dystonia respond best to DBS; however, the therapy offers good outcomes for other types of dystonia as well,” says Dr. Jafrani. “Since gaining FDA approval in 2108, DBS has also become an excellent option for certain patients with medically refractory epilepsy.”

Advances in technology and surgical techniques allow skilled pediatric neurosurgeons to perform DBS surgery safely and accurately in children under general anesthesia, obviating the need for awake surgery or intraoperative testing as it's commonly done in adult DBS procedures. This alternative to traditional awake surgery is better tolerated and less traumatizing to pediatric patients.

Dr. Jafrani explains that “while DBS for dystonia and certain types of epilepsy in children has been well established, supported by excellent level 1 evidence from clinical trials, there are several other indications currently under investigation that show promise. DBS therapy, which has well-established benefits in adults with medically refractory obsessive-compulsive disorder (OCD) and Tourette syndrome, is likely to expand to pediatric patients in the coming years. Other indications under investigation that show promise in both children and adults include treatment for obesity, depression, and other movement disorders."

With one of the largest pediatric neurosurgery programs in Florida, the Leon Pediatric Neuroscience Center of Excellence at Orlando Health Arnold Palmer offers leading-edge surgical techniques and expertise in all areas of pediatric neurosurgery, from minimally invasive surgery such as DBS and laser interstitial thermal therapy (LITT) to the most complex open cranial, spine and peripheral nerve procedures. It is the only center in Florida and one of the few practices in the Southeast with a fetal neurosurgery program.