Abstract
The role of deep brain stimulation (DBS) in children has grown from historical beginnings as a clinical necessity to manage a child with a rare genetic Dyt-1-positive dystonia in status dystonicus in the mid-1990s to the present day, encouraging clinicians to re-examine in detail accepted models of neurological disease and to re-engage in exploring the delicate neuroanatomical-physiological processes underpinning brain function and adaptation to developmental experience. Important factors influencing the success of DBS include: clinical characterization of movement disorders (phenotype and genotype); severity; temporal factors such as timing of DBS after onset and age at DBS intervention; choosing neurosurgical targets; outcome measures; technical hardware issues and the sociological-ethical context of DBS in childhood. While much has been learned, more remains to be discovered in the systematic clinical applications of DBS which should be seen as a means of improving activity and participation and thus enhancing the lives of children with movement disorders.
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