Risk Factors for Dystonia after Selective Dorsal Rhizotomy in Nonwalking Children and Adolescents with Bilateral Spasticity

Laura A. van de Pol, Jeroen R. Vermeulen, Charlotte van 'T Westende, Petra E.M. van Schie, Eline A.M. Bolster, Pim W.J.R. van Ouwerkerk, Rob L. Strijers, Jules G. Becher, Agnita Stadhouder, Pim de Graaf, Annemieke I. Buizer

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

We recently showed a beneficial effect of selective dorsal rhizotomy (SDR) on daily care and comfort in nonwalking children with severe bilateral spasticity. However, despite careful selection, some patients showed dystonia after the intervention, in which cases caregivers tended to be less satisfied with the result. The aim of this study is to identify risk factors for dystonia after SDR in children and adolescents with severe bilateral spasticity (GMFCS levels IV/V). Clinical and MRI risk factors for dystonia after SDR were studied in our cohort of 24 patients. Patients with clinical evidence of dystonia and brain MRI showing basal ganglia abnormalities were excluded for SDR. Nine of 24 patients (38%) showed some degree of dystonia after SDR. There was a significant association between the cause of spasticity and dystonia after SDR; in six (67%) patients with a congenital disorder, dystonia was present versus three (20%) with an acquired disorder (Chi-squared test: C(1) = 5.23, p = 0.02). This study allows more optimal selection of patients that may benefit from SDR. Patients with an acquired cause of spasticity, when selected carefully on clinical examination and MRI, rarely show dystonia after SDR. However, patients with an underlying congenital disorder have a considerable risk of dystonia after SDR.

Original languageEnglish
Pages (from-to)44-50
Number of pages7
JournalNeuropediatrics
Volume49
Issue number1
DOIs
Publication statusPublished - Feb 2018

Cite this

@article{659820b81e4f447aaedcf503b4a528ce,
title = "Risk Factors for Dystonia after Selective Dorsal Rhizotomy in Nonwalking Children and Adolescents with Bilateral Spasticity",
abstract = "We recently showed a beneficial effect of selective dorsal rhizotomy (SDR) on daily care and comfort in nonwalking children with severe bilateral spasticity. However, despite careful selection, some patients showed dystonia after the intervention, in which cases caregivers tended to be less satisfied with the result. The aim of this study is to identify risk factors for dystonia after SDR in children and adolescents with severe bilateral spasticity (GMFCS levels IV/V). Clinical and MRI risk factors for dystonia after SDR were studied in our cohort of 24 patients. Patients with clinical evidence of dystonia and brain MRI showing basal ganglia abnormalities were excluded for SDR. Nine of 24 patients (38{\%}) showed some degree of dystonia after SDR. There was a significant association between the cause of spasticity and dystonia after SDR; in six (67{\%}) patients with a congenital disorder, dystonia was present versus three (20{\%}) with an acquired disorder (Chi-squared test: C(1) = 5.23, p = 0.02). This study allows more optimal selection of patients that may benefit from SDR. Patients with an acquired cause of spasticity, when selected carefully on clinical examination and MRI, rarely show dystonia after SDR. However, patients with an underlying congenital disorder have a considerable risk of dystonia after SDR.",
keywords = "cerebral palsy, dystonia, intervention, MRI, SDR, spasticity",
author = "{van de Pol}, {Laura A.} and Vermeulen, {Jeroen R.} and {van 'T Westende}, Charlotte and {van Schie}, {Petra E.M.} and Bolster, {Eline A.M.} and {van Ouwerkerk}, {Pim W.J.R.} and Strijers, {Rob L.} and Becher, {Jules G.} and Agnita Stadhouder and {de Graaf}, Pim and Buizer, {Annemieke I.}",
note = "Georg Thieme Verlag KG Stuttgart · New York.",
year = "2018",
month = "2",
doi = "10.1055/s-0037-1607395",
language = "English",
volume = "49",
pages = "44--50",
journal = "Neuropediatrics",
issn = "0174-304X",
publisher = "Hippokrates Verlag GmbH",
number = "1",

}

Risk Factors for Dystonia after Selective Dorsal Rhizotomy in Nonwalking Children and Adolescents with Bilateral Spasticity. / van de Pol, Laura A.; Vermeulen, Jeroen R.; van 'T Westende, Charlotte; van Schie, Petra E.M.; Bolster, Eline A.M.; van Ouwerkerk, Pim W.J.R.; Strijers, Rob L.; Becher, Jules G.; Stadhouder, Agnita; de Graaf, Pim; Buizer, Annemieke I.

In: Neuropediatrics, Vol. 49, No. 1, 02.2018, p. 44-50.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Risk Factors for Dystonia after Selective Dorsal Rhizotomy in Nonwalking Children and Adolescents with Bilateral Spasticity

AU - van de Pol, Laura A.

AU - Vermeulen, Jeroen R.

AU - van 'T Westende, Charlotte

AU - van Schie, Petra E.M.

AU - Bolster, Eline A.M.

AU - van Ouwerkerk, Pim W.J.R.

AU - Strijers, Rob L.

AU - Becher, Jules G.

AU - Stadhouder, Agnita

AU - de Graaf, Pim

AU - Buizer, Annemieke I.

N1 - Georg Thieme Verlag KG Stuttgart · New York.

PY - 2018/2

Y1 - 2018/2

N2 - We recently showed a beneficial effect of selective dorsal rhizotomy (SDR) on daily care and comfort in nonwalking children with severe bilateral spasticity. However, despite careful selection, some patients showed dystonia after the intervention, in which cases caregivers tended to be less satisfied with the result. The aim of this study is to identify risk factors for dystonia after SDR in children and adolescents with severe bilateral spasticity (GMFCS levels IV/V). Clinical and MRI risk factors for dystonia after SDR were studied in our cohort of 24 patients. Patients with clinical evidence of dystonia and brain MRI showing basal ganglia abnormalities were excluded for SDR. Nine of 24 patients (38%) showed some degree of dystonia after SDR. There was a significant association between the cause of spasticity and dystonia after SDR; in six (67%) patients with a congenital disorder, dystonia was present versus three (20%) with an acquired disorder (Chi-squared test: C(1) = 5.23, p = 0.02). This study allows more optimal selection of patients that may benefit from SDR. Patients with an acquired cause of spasticity, when selected carefully on clinical examination and MRI, rarely show dystonia after SDR. However, patients with an underlying congenital disorder have a considerable risk of dystonia after SDR.

AB - We recently showed a beneficial effect of selective dorsal rhizotomy (SDR) on daily care and comfort in nonwalking children with severe bilateral spasticity. However, despite careful selection, some patients showed dystonia after the intervention, in which cases caregivers tended to be less satisfied with the result. The aim of this study is to identify risk factors for dystonia after SDR in children and adolescents with severe bilateral spasticity (GMFCS levels IV/V). Clinical and MRI risk factors for dystonia after SDR were studied in our cohort of 24 patients. Patients with clinical evidence of dystonia and brain MRI showing basal ganglia abnormalities were excluded for SDR. Nine of 24 patients (38%) showed some degree of dystonia after SDR. There was a significant association between the cause of spasticity and dystonia after SDR; in six (67%) patients with a congenital disorder, dystonia was present versus three (20%) with an acquired disorder (Chi-squared test: C(1) = 5.23, p = 0.02). This study allows more optimal selection of patients that may benefit from SDR. Patients with an acquired cause of spasticity, when selected carefully on clinical examination and MRI, rarely show dystonia after SDR. However, patients with an underlying congenital disorder have a considerable risk of dystonia after SDR.

KW - cerebral palsy

KW - dystonia

KW - intervention

KW - MRI

KW - SDR

KW - spasticity

UR - http://www.scopus.com/inward/record.url?scp=85033373655&partnerID=8YFLogxK

U2 - 10.1055/s-0037-1607395

DO - 10.1055/s-0037-1607395

M3 - Article

VL - 49

SP - 44

EP - 50

JO - Neuropediatrics

JF - Neuropediatrics

SN - 0174-304X

IS - 1

ER -