Celiac Plexus Block to Treat Refractory Feed Induced Dystonia in Children with Severe Neurodisability: A Single Center Case Series

Area of Science:

• Pediatric Gastroenterology
• Interventional Radiology
• Pain Management

Background:

• Children with severe neurodisability often suffer from refractory feed intolerance, pain, or dystonia.
• The neuroenteric system is significantly impacted by feeding issues in this population.
• Existing therapies may be insufficient for managing these complex conditions.

Purpose of the Study:

• To describe the procedure, safety, and outcomes of celiac plexus blockade (CPB) in children with neurodisability and feeding problems.
• To evaluate CPB as a treatment for feed-induced dystonia (FID) and refractory feed intolerance.
• To review the pathophysiological response to feeding in neurodisabled children.

Main Methods:

• A 2-stage CT-guided temporary celiac plexus blockade followed by neurolysis technique was employed.
• A case series of 5 pediatric patients with life-limiting conditions and significant disability was compiled.
• The study involved 10 separate procedures in the 5 children.

Main Results:

• Celiac plexus blockade (CPB) demonstrated positive outcomes in 3 out of 4 cases of pediatric feed-induced dystonia (FID).
• Two of three patients on parenteral nutrition showed improved feed tolerance post-procedure.
• All pediatric patients tolerated the procedure well, with no documented post-procedure complications.

Conclusions:

• Celiac plexus blockade (CPB) is a safe treatment option for selected pediatric cases.
• CPB can effectively manage life-threatening feed-induced dystonia or intestinal failure when other treatments have failed.
• This interventional technique offers a viable solution for refractory feeding issues in neurodisabled children.