ORIGINAL PAPER DBS in pediatric patients: institutional experience Huseyin Canaz 1 & Isik Karalok 2 & Baris Topcular 3 & Mert Agaoglu 4 & Zuhal Yapici 5 & Sabri Aydin 1 Received: 1 April 2018 /Accepted: 14 May 2018 # Springer-Verlag GmbH Germany, part of Springer Nature 2018 Abstract Introduction DBS is initially used for treatment of essential tremor and Parkinson’ s disease in adults. In 1996, a child with severe life-threatening dystonia was offered DBS to the internal globus pallidus (GPi) with lasting efficacy at 20 years. Since that time, increasing number of children benefited from DBS. Patients and methods We retrospectively evaluated our database of patients who underwent DBS from 2011 to 2017. All patients ≤ 17 years of age at the time of implantation of DBS were included in this series. Subjective Benefit Rating Scale (SBRS), Hoehn Yahr Scale (HYS), Fahn Marsden Rating Scale (FMRS), Clinical Global Impressions Scales (CGI), and Yale Global Tic Severity Scale (YGT) were used to evaluate clinical outcome. Results Between May 2014 and October 2017, 11 children underwent DBS procedure in our institution. Six of them were female and five of them were male. Mean age at surgery was 11.8 ± 4.06 years (range 5–17 years). In our series, four patients had primary dystonia (PDY) (36.3%), three patients had secondary dystonia (SDY) (27.2%), two patients had JP (18.1%), and two patients had Tourette Syndrome (TS) (18.1%). Two JP patients underwent bilateral STN DBS while the other nine patients underwent bilateral GPi DBS. SBRS scores were 1.75 ± 0.5 for patients with PDY, 3 ± 0 for patients with JP, 2.5 ± 0.7 for patients with TS, and 2 ± 1 for patients with SDY. Mean FMRS reduction rate was 40.5 for patients with dystonia. Significant improvement was also defined in patients with TS and JP after DBS. None of the patients experienced any intracerebral hemorrhage or other serious adverse neurological effect related to the DBS. Wound complications occurred in two patients. Conclusion There are many literatures that support DBS as a treatment option for pediatric patients with medically refractory neurological disorders. DBS has replaced ablative procedures as a treatment of choice not only for adult patients, but also for pediatric patients. Wound-related complications still remain the most common problem in pediatric patients. Development of smaller and more flexible hardware will improve quality of children’ s life and minimize wound-related complications in the future. Keywords Deep brain stimulation . Dystonia . GPi . Juvenile parkinsonism . STN . Tourette syndrome Introduction Deep brain stimulation (DBS) is initially used for treatment of essential tremor and Parkinson’ s disease (PD) in adults. It currently plays an established role in the management of movement disorders, providing durable symptom relief and improved quality of life with minimal morbidity and side ef- fects. In addition, the role of DBS procedures is currently under investigation in many other neurological psychiatric disorders previously considered to be beyond the realm of neurosurgery [ 1 ]. In 1996, a child with severe life- threatening dystonia was offered DBS to the internal globus pallidus (GPi) with lasting efficacy at 20 years. Since that time, increasing number of children benefited from DBS [2]. DBS may have a large effect on pediatric patients, in areas such as social integration, completion of education, and ability to work. * Huseyin Canaz huseyin.canaz@istanbulbilim.edu.tr 1 Department of Neurosurgery, Florence Nightingale Hospital, Istanbul Bilim University, Abide-i Hurriyet Cad. No:164 Sisli, Istanbul, Turkey 2 Department of Radiology, Istanbul Bilim University, Istanbul, Turkey 3 Department of Neurology, Istanbul Bilim University, Istanbul, Turkey 4 Medtronic, Istanbul, Turkey 5 Division of Pediatric Neurology, Department of Neurology, Istanbul University, Istanbul, Turkey Child's Nervous System https://doi.org/10.1007/s00381-018-3839-1