Neoplasms

Symptoms and General Pathology

All Conditions

Nervous System Diseases

Neoplasm Metastasis

Dystonia

Dystonic Disorders

Neoplastic Processes

Dyskinesias

Neurologic Manifestations

Movement Disorders

Central Nervous System Diseases

Muscle Relaxants, Central

All Drugs and Chemicals

Baclofen

GABA Agonists

Neurotransmitter Agents

Stereotactic lesioning of the thalamus or gloves pallidus

Combined anterior and posterior lumbosacral rhizotomy

Bilateral globus pallidus internus deep brain stimulation

Stereotactic radiofrequency lesioning of the pallidum or thalamus

Brain Lesioning

Deep brain stimulation

Intra-thecal baclofen infusion

Walid A Abdel Ghany, MD

The disability inflected by dystonia encouraged the development of many neurosurgical procedures.

This is a prospective study included 120 patients suffering from intractable secondary dystonia.

They were subjected to different neurosurgical treatments and were assessed through the follow up period

Background:

Secondary dystonia are the syndromes that have dystonic symptoms due to brain insult which can be associated with neonatal encephalopathy syndromes, trauma, vascular injury, infections, demyelinations, or hereditary disorders associated with neurodegenerative process. The disability inflected by dystonia encouraged the development of many neurosurgical procedures in order to improve the quality of life of these patients.

The aim of this study was to compare the outcomes of different Neuroablative and modulation techniques in treatment of secondary dystonia.

Patients and methods This is a prospective study included 120 patients suffering from intractable secondary dystonia. Ablative techniques included the brain lesioning procedure and combined anterior and posterior lumbar rhizotomy (CAPR). Modulation techniques included deep brain stimulation (DBS) and intrathecal baclofen therapy (ITB). Patients with focal dystonia were included in the Botulinum toxin injection group. Patients with generalized dystonia were included in either of the brain lesioning or the deep brain stimulation, and patients with predominant affection of both lower limbs were included in either of the (CAPR) or the (ITB) groups.

Assessment measures included the evaluation of the muscle tone, range of motion, and the Burke-Fahn-Marsden dystonia rating scale through a follow up period of one year.

Neuroablation Versus Neuromodulation Techniques for Treatment of Secondary Dystonia

Comparative Study Between the Functional Outcomes of Neuromodulation and Neuroablation Techniques for Treatment of Secondary Dystonia

Dystonia rating scale Higher scores means a worse condition of the disease, while low scores indicate a less involvement of the body

Ain Shams University

Fellow

Wounds and Injuries

Rare Diseases

Cerebral Palsy

Paralysis

Brain Injuries

Brain Damage, Chronic

Brain Diseases

Chronic Graft Versus Host Disease

Dystonia is the most common movement disorder in the pediatric population after spasticity. It can affect normal motor development and cause significant motor retardation. The presence of dystonia may affect motor function, pain, and ease of care in CP. Additionally, it can cause serious difficulties in daily living activities and social participation and long-term joint deformity. The increase in the severity of dystonia in CP children with secondary dystonia may affect the quality of life, activity and participation of the children, as well as the caregiver. The importance of caregivers is an undeniable fact, especially in these patient groups. This study aims to investigate the burden of dystonia severity on the participation in daily living activities and caregivers of children with CP with secondary dystonia.

It's an observational study. Purpose of the study: Investigating the burden of dystonia severity on the participation in daily living activities and caregivers of children with CP with secondary dystonia.

* Does dystonia severity affect participation in daily life activities in CP children with secondary dystonia?
* Does the severity of dystonia in children with CP with secondary dystonia affect the burden on the caregiver?
* Are the participation in daily living activities and caregiver burden of children with CP with secondary dystonia related to each other?

Total of 20 CP cases with secondary dystonia who applied to Acıbadem University Department of Pediatric Neurosurgery will be included in the study.

Dystonia severity of these cases will be evaluated with the Barry-Albright Dystonia Scale (BADS). Children's participation in daily living activities will be evaluated with The Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD), and the burden on the caregiver will be evaluated with the Care and Comfort Hypertonicity Questionnaire (CCHQ).

The Effect of Dystonia Severity on Participation in Daily Living Activities and Caregivers in Children of Cerebral Palsy With Secondary Dystonia

Individual participant data will not be made available to other researchers.

The Barry-Albright Dystonia Scale designed for secondary dystonia and presence of dystonia in various body parts. It is a 5-point, criterion-based, ordinal scale designed to assess dystonia in eight body regions: eyes, mouth, neck, trunk, and the four extremities. Raters score dystonia as none (0), slight (1), mild (2), moderate (3), or severe (4).

The Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD) is a measure of caregivers' perceptions of activity limitations, health status, well-being, and ease of care for children with severe cerebral palsy (CP). The CPCHILD consists of 36 items comprising the following domains: (1) Personal Care; (2) Positioning, Transfer, and Mobility; (3) Communication and Social Interaction; (4) Comfort, Emotions, and Behavior; (5) Health; and (6) Overall Quality Of Life.

The Care and Comfort Hypertonicity Questionnaire (CCHQ) is an interview questionnaire consisting of 27 questions divided into four scales: personal care,positioning/transferring, comfort and interaction/communication. Questions are answeredusing a 7-point Likert scale; mean scale score is calculated. The interview takes approximately10 min to administer. It provides a measure of functional limitation and has some quality-of-life elements with questions relating to pain and self-esteem. It indicates disease severity interms of degree of disability.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Neuroablation Versus Neuromodulation Techniques for Treatment of Secondary Dystonia	NCT03347240	Secondary Dysto...	Brain Lesioning Combined anteri... Deep brain stim... Intra-thecal ba...	3 Years - 50 Years	Ain Shams University
The Effect of Dystonia Severity on Participation in Daily Living Activities and Caregivers in Children of Cerebral Palsy With Secondary Dystonia	NCT06307561	Secondary Dysto... Cerebral Palsy,...		3 Years - 15 Years	Acıbadem Atunizade Hospital
Neuroablation Versus Neuromodulation Techniques for Treatment of Secondary Dystonia	NCT03347240	Secondary Dysto...	Brain Lesioning Combined anteri... Deep brain stim... Intra-thecal ba...	3 Years - 50 Years	Ain Shams University
The Effect of Dystonia Severity on Participation in Daily Living Activities and Caregivers in Children of Cerebral Palsy With Secondary Dystonia	NCT06307561	Secondary Dysto... Cerebral Palsy,...		3 Years - 15 Years	Acıbadem Atunizade Hospital

Spots Global Cancer Trial Database for secondary dystonia