Recommendations for the Management of Initial and Refractory Pediatric Status Dystonicus

Author:

Vogt Lindsey M.1,Yang Kathryn12,Tse Gabriel3,Quiroz Vicente2,Zaman Zainab2,Wang Laura1,Srouji Rasha2,Tam Amy2,Estrella Elicia2,Manzi Shannon4,Fasano Alfonso56ORCID,Northam Weston T.7,Stone Scellig7,Moharir Mahendranath1,Gonorazky Hernan1,McAlvin Brian8,Kleinman Monica8,LaRovere Kerri L.9,Gorodetsky Carolina15ORCID,Ebrahimi‐Fakhari Darius29ORCID

Affiliation:

1. Division of Neurology, Department of Pediatrics The Hospital for Sick Children Toronto Ontario Canada

2. Movement Disorders Program, Department of Neurology, Boston Children's Hospital Harvard Medical School Boston Massachusetts USA

3. Division of Pediatric Hospital Medicine, Department of Pediatrics Stanford University School of Medicine Palo Alto California USA

4. Department of Pharmacy, Boston Children's Hospital Harvard Medical School Boston Massachusetts USA

5. Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital University Health Network Toronto Ontario Canada

6. Krembil Brain Institute University of Toronto Toronto Ontario Canada

7. Department of Neurosurgery, Boston Children's Hospital Harvard Medical School Boston Massachusetts USA

8. Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital Harvard Medical School Boston Massachusetts USA

9. Neurocritical Care Consult Service, Department of Neurology, Boston Children's Hospital Harvard Medical School Boston Massachusetts USA

Abstract

AbstractStatus dystonicus is the most severe form of dystonia with life‐threatening complications if not treated promptly. We present consensus recommendations for the initial management of acutely worsening dystonia (including pre–status dystonicus and status dystonicus), as well as refractory status dystonicus in children. This guideline provides a stepwise approach to assessment, triage, interdisciplinary treatment, and monitoring of status dystonicus. The clinical pathways aim to: (1) facilitate timely recognition/triage of worsening dystonia, (2) standardize supportive and dystonia‐directed therapies, (3) provide structure for interdisciplinary cooperation, (4) integrate advances in genomics and neuromodulation, (5) enable multicenter quality improvement and research, and (6) improve outcomes. © 2024 International Parkinson and Movement Disorder Society.

Publisher

Wiley

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