[Movement disorders in childhood: therapeutic update].
Abnormal movements are not uncommon in childhood. Due to the severity of the abnormal movements or to the functional disability, a medical treatment is often required; the wide range of available pharmacological molecules and the absence of therapeutic consensus highlight the limited efficacy of the medical treatment on dystonic or athetoid movements, or severe tic disorders. The recent identification of the enzymatic defect implicated in metabolic diseases led to the development of specific treatment for newly recognized disorders, with more or less interesting results (creatine ou biotine supplementation). Recent progress in functional neurosurgery opened new fields in the treatment of movement disorders. Intrathecal baclofen was proved effective in the treatment of secondary dystonia, especially in patients with cerebral palsy. Deep brain stimulation is now an established therapy for patients with a generalized dystonic syndrome. Given the successful results of pallidal stimulation in dystonia, the indication of this procedure has been discussed in other types of abnormal movements.
Service de neuropédiatrie, hôpital Saint-Eloi, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France. a_roubertie@hotmail.com
A
A
Roubertie
J
J
Leydet
F
F
Rivier
V
V
Humbertclaude
R
R
Cheminal
B
B
Echenne
D018726:Anti-Dyskinesia Agents / Q000627:therapeutic use; D001418:Baclofen / Q000627:therapeutic use; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use; D002648:Child; D032921:Consensus; D004599:Electric Stimulation Therapy; D005917:Globus Pallidus / Q000601:surgery; D006801:Humans; D009069:Movement Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D009125:Muscle Relaxants, Central / Q000627:therapeutic use; D009465:Neuromuscular Agents / Q000627:therapeutic use; D018579:Patient Selection; D010372:Pediatrics / Q000379:methods* / Q000639:trends; D017410:Practice Guidelines as Topic; D012107:Research Design / Q000592:standards; D013747:Tetrabenazine / Q000627:therapeutic use; D016896:Treatment Outcome
D018726:Anti-Dyskinesia Agents; D009125:Muscle Relaxants, Central; D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A; D001418:Baclofen; D013747:Tetrabenazine