"He went in a wheelchair and walked out."

BarcelonaBy the time he was nine, Darío had already visited several clinics throughout Valencia to treat the involuntary muscle contractions that limited his movement and almost prevented him from walking. This condition was worsening, and the professionals couldn't determine the appropriate treatment. Furthermore, the medications they prescribed caused side effects such as severe pain and even blindness. But in 2020, at the height of the pandemic, Darío's family received a call: "It changed our lives," admits Jaime López, the boy's father. The caller was Dr. Belén Pérez, head of pediatric neurology at Vall d'Hebron Hospital, who offered them the opportunity to come to Barcelona to begin treatment. The neurologist determined that Darío suffered from dystonia, a condition that, along with Parkinson's disease and essential tremor, is characterized by a movement disorder. It is common for patients with this condition to visit the Neurology and Pediatric Neurology departments of the Germans Trias i Pujol and Vall d'Hebron hospitals. In fact, the Ministry of Health has designated them as the reference centers (CSUR) in Catalonia for the surgical treatment of patients with movement disorders, whether adult or pediatric.

A pacemaker that regulates neurons

The most common method used by surgeons at these centers is deep brain stimulation (DBS), which, as the doctor explains, "is like a brain pacemaker that regulates the heartbeat of malfunctioning neurons." The patient has a small generator implanted under the skin at hip level, from which wires extend to the brain, sending electrical impulses to regulate dysfunctional neural circuits and, consequently, control involuntary movements. The rejection or failure rate is very low, the neurologist acknowledges, and "if the patient doesn't respond well, the parameters can be reprogrammed to adapt to the current being administered. The worst that can happen is that they remain as they were, but they will never get worse."

Despite being a well-known neurosurgical treatment internationally and nationally, its use is still inconsistent in some regions, which is why Darío's family is so grateful to the medical team at Vall d'Hebron. "We thought we were going to lose our son," his mother admits, but only 15 days passed between the doctor's initial contact and Darío's surgery. "He went into the hospital in a wheelchair and came out walking," she describes. "Now I'm independent and only depend on myself," the young boy celebrates, five years after the operation.

Since Germans Trias i Pujol and Vall d'Hebron implemented this surgical methodology, they have been able to improve the quality of life of nearly 300 people by offering a faster and more efficient alternative to conventional drug treatments. But deep brain stimulation is not the only procedure available to improve movement disorders: for patients who have limitations when receiving DBS, high-intensity focused ultrasound (HIFU) is also offered, an alternative with similar techniques that has shown improvements over previous treatments. At Vall d'Hebron, 50 pediatric patients with severe dystonia have already undergone this pioneering procedure, and the results have been very successful. So much so that 75% of the children come from outside Catalonia for surgery, and the distinction awarded by the Ministry of Health will make it easier for any patient from across Spain to be treated at these hospitals, which, thanks to their experience, have perfected the techniques and care for patients with these conditions. The hospital's professionals are optimistic about this distinction and are already thinking about how to take advantage of it: "Many children who haven't had surgery will be able to come and receive treatment with us. If we were operating on 10 patients a year, from now on we want to reach at least 20 or 30," says Dr. Pérez.