Revisiting Deep Brain Stimulation in a Pediatric-Onset Dystonia Case: Pamela Zeilman, NP

WATCH TIME: 6 minutes

"[It’s] a great case to present because it shows both the loss and benefit that we sometimes see as these kids transition into adulthood and have some changes in their phenomenology. Then, [you see how we can] rescue them with another surgery. Many of these patients, we don’t have to rescue with another surgery, but it’s just a good case to highlight how you would problem-solve those types of scenarios."

Deep brain stimulation (DBS) has been considered an important therapeutic innovation over the last few decades for patients with movement disorders including Parkinson disease (PD), dystonia, and tremor. In comparison with traditional treatment alone, previous studies have shown significant improvements in motor, nonmotor, and particularly quality-of-life outcomes for patients with advanced PD that could not be improved with medication, and also for patients with PD who had only early fluctuations.¹ Additional research suggests the potential for a more pathophysiology-based approach to DBS for various brain circuit disorders like movement disorders.

At the recently concluded 4th Annual Advanced Therapeutics in Movement and Related Disorders (ATMRD) Congress, held by the PMD Alliance from June 27-30, 2025, several movement disorder experts presented patient cases displaying different scenarios of advanced DBS techniques used. Among them included Pamela Zeilman, NP, nurse practitioner in the Center for Movement Disorders & Neurorestoration at the University of Florida, and Fahd Amjad, MD, MS, neurologist and assistant professor of neurology in the Movement Disorder Division at Medstar Georgetown University Hospital.²

Following the session, Zeilman sat down to have a deeper conversation with NeurologyLive^® about the case review she presented at the Congress. In the interview, Zeilman spoke about the first case she presented, which covered a young patient with early-onset isolated dystonia who underwent early DBS. She noted that although the patient initially experienced significant improvement, a gradual loss of benefit was observed as the child grew older. After a revision surgery, she explained that the patient had near-complete suppression of symptoms, highlighting the value of individualized, team-based decision-making in complex DBS cases.

Click here for more coverage of ATMRD 2025.

REFERENCES
1. Krack P, Volkmann J, Tinkhauser G, Deuschl G. Deep Brain Stimulation in Movement Disorders: From Experimental Surgery to Evidence-Based Therapy. Mov Disord. 2019;34(12):1795-1810. doi:10.1002/mds.27860
2. Zeilman P, Amjad F. DBS Advanced Techniques Case Review. Presented at: ATMRD; June 27-30, 2025; Washington, DC.