BackgroundChildhood arterial ischemic stroke (CAIS) is increasingly recognized as an important cause of significant long-term morbidity in the pediatric population. Post stroke movement disorders, above all hemi-dystonias, are much more common in children after stroke compared to adults. However, research in this field is largely lacking. By highlighting some important knowledge gaps, we aim to encourage future collaborative research projects in this particular field.FindingsPost stroke-dystonia seems to be much more common among children than adults. However, no reliable epidemiological data of post-stroke movement disorders in childhood are available, and differentiation between spasticity and dystonia can be challenging. Pharmacotherapy for dystonia is limited by lack of effect, especially in the long-term treatment. The pathophysiology of dystonia is complex and incompletely understood. Recent findings from functional imaging studies suggest that dystonia does not result from a single lesion but rather network dysfunctions and abnormalities in functional connectivity. However, very few patients with post stroke dystonia have been studied, and it is not clear to what extent pathophysiology of primary and post stroke ischemia shares common characteristics on network level. In general, progress in understanding the nature of childhood dystonia lags far behind adult onset CNS diseases.ConclusionsDystonia after CAIS is a common yet insufficiently understood and poorly studied clinical challenge. Studies to improve our understanding of the underlying pathophysiology and consequently the development of instruments for early prediction as well as targeted treatment of dystonia should become a high priority in collaborative childhood stroke research.

中文翻译：

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儿童中风后半肌张力障碍：一个被忽视的研究领域

背景儿童动脉缺血性卒中 (CAIS) 越来越被认为是导致儿童长期发病的重要原因。中风后运动障碍，尤其是半肌张力障碍，与成人相比，在中风后儿童中更为常见。然而，这方面的研究很大程度上缺乏。通过突出一些重要的知识差距，我们旨在鼓励未来在这一特定领域的合作研究项目。发现中风后肌张力障碍似乎在儿童中比成人更常见。然而，没有关于儿童卒中后运动障碍的可靠流行病学数据，区分痉挛和肌张力障碍可能具有挑战性。肌张力障碍的药物治疗效果不佳，尤其是长期治疗效果不佳。肌张力障碍的病理生理学是复杂的且尚未完全了解。功能成像研究的最新发现表明，肌张力障碍不是由单个病变引起的，而是由网络功能障碍和功能连接异常引起的。然而，对卒中后肌张力障碍患者的研究很少，并且尚不清楚原发性和卒中后缺血的病理生理学在网络水平上的共同特征有多大。总的来说，对儿童肌张力障碍本质的理解远远落后于成人中枢神经系统疾病。结论 CAIS 后肌张力障碍是一种常见但尚未充分了解和研究不足的临床挑战。