Abstract
Objective: To determine the indications and outcomes of deep brain stimulation (DBS) surgery among the pediatric population in the United States.
Background: Deep brain stimulation (DBS) surgery has transformed the management of Parkinson’s disease, dystonia, tremors and other movement disorders. Newer indications and targets continue to emerge. However, there is a paucity of data about the outcomes and different indications for DBS surgery in children.
Design/Methods: All pediatric admissions (patients younger than 21 years) for DBS surgery in the United States (US) from 2003–2012 were identified from the Kids’ Inpatient Database. DBS surgery and movement disorder diagnoses were defined using the International Classification of Disease, ninth edition diagnostic codes.
Results: 228 pediatric DBS surgeries were identified during this period. Dystonia, representing 58.9%(N=134) of the patients, is the most common indication for DBS surgery. Other indications include cerebral palsy (12.2%), tremor (7.7%), tics/Tourette’s syndrome (4.4%), chorea (2%), Parkinson’s disease (0.6%), and other movement disorders (14.2%). The patients were predominantly male (65%) and Caucasian (71%). The mean age was 14.5 years and 65% of the procedures were performed in the 8–18-year age group. The average cost of hospitalization was approximately $43,900. No mortality or surgical removal of device were reported during the hospitalization. Complications were reported in 11.8% of the patients as follows: mechanical complication of the device (7.3%), urinary tract infection (2.5%), respiratory infections (1.9%), central nervous system infections (1.8%) and infarction/hematoma (0.7%) Uncommon movement disorder diagnoses tend to be associated longer hospitalization and higher cost.
Conclusions: The most common indication for DBS surgery in the pediatric population is dystonia and the procedure is associated with 11.8% complication rate but no mortality.
Disclosure: Dr. Akano has nothing to disclose. Dr. Otite has nothing to disclose. Dr. Lavenstein has nothing to disclose. Dr. Ehrlich has nothing to disclose.
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