Electrical Stimulation of the Centromedian Thalamic Nucleus in Control of Seizures: Long-Term Studies

摘要: Five patients with chronic incapacitating seizures averaging 15-5,000/month were selected for study. All had more than one seizure type and received maximal doses of antiepileptic drugs (AEDs). The centromedian thalamic nucleus (CM) was stimulated electrically through bilateral multicontact platinum electrodes stereotaxically placed in CM connected to internalized pulse generators. Electrophysiologic confirmation electrode position included thalamically elicited recruiting responses EEG desynchronization recorded at the scalp. Stimulation parameters adjusted individually range 450-800-microA intensity, 65 pps, 0.09 ms, 1-min trains, alternating right left side stimulation 4-min intervals delivered 2 h/day. Quantitative evaluation frequency seizures/month, number interictal paroxysmal discharges, background activities counted scalp samples, taken throughout observation period (7-33 months). Significance changes evaluated by parametric Student's t test. Generalized tonic-clonic (GTC) decreased dramatically, almost disappearing all cases (p < 0.001), a significant reduction discharges 0.01) tendency toward an increase frequency. Other generalized (atypical absences) significantly, but there no change complex partial (CPS). is useful control GTC, its beneficial effect on other types has not been established.