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Dystonia Scales for Children: Challenges and Obstacles in DBS Practice
Marcela Montiel1, Carolina Gorodetsky2, Laura Cif3,4
1Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Toronto, Ontario, Canada.
Background:
Dystonia in pediatric patients often coexists with other movement disorders and neurodevelopmental issues. Current rating scales for evaluating pediatric deep brain stimulation (DBS) candidates are not universally applicable and often require a non-validated combination of the existing scales.
Objectives:
To evaluate dystonia scales used in pediatric patients, focusing on their application in DBS.
Methods:
A scoping review identified the most widely used scales in pediatric DBS candidates.
Results:
The Fahn-Marsden Dystonia Rating Scale was the most frequently chosen (94.3%), often as a sole scale (78.2%). The Barry Albright Dystonia Scale followed (12.9%). The Unified Dystonia Rating Scale, Global Dystonia Rating Scale, Dyskinesia Impairment Scale and Movement Disorders in Childhood Rating Scale, were used less frequently (5.6%, 4%, 2.4% and 0.8%, respectively). Only 12% of studies included a quality-of-life scale.
Conclusions:
There is a need for a new pediatric dystonia scale for evaluating DBS candidates considering developmental and functional challenges.
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