Current therapies and therapeutic decision making for childhood‐onset movement disorders

摘要: Movement disorders differ in children to adults. First, neurodevelopmental movement such as tics and stereotypies are more prevalent than parkinsonism, second, there is a genomic revolution which now explaining many early-onset dystonic syndromes. We outline an approach with starting defining the phenomenology, determining level of functional impairment due abnormal movements, screening for comorbid psychiatric conditions cognitive impairments often contribute disability movements themselves. The rapid improvement our understanding etiology has resulted increasing focus on precision medicine, targeting treatable modifiable disease processes. profile some key disease-modifying therapies metabolic, neurotransmitter, inflammatory, autoimmune gene or cellular therapies. When no possible, symptomatic all that available. These classically target dopaminergic, cholinergic, alpha-adrenergic, GABAergic neurochemistry. Increasing interest neuromodulation highlighted clinical syndromes respond better DBS, further highlights importance "disease-specific" future individualized according findings pathways disrupted. summarize pragmatic applications therapies, techniques, rehabilitative interventions provide contemporary overview treatment childhood-onset disorders. © 2019 International Parkinson Disorder Society.