Abstract |
Electrical stimulation (ES) of the thalamic centromedian nucleus (CMN) has been proposed as a minimally invasive alternative for the treatment of difficult-to-control seizures of multifocal origin and seizures that are generalized from the onset. ES intends to interfere with seizure propagation in a non-specific manner through the thalamic system. By adopting a frontal parasagittal approach and based on anterior-posterior (AC-PC) commissure intersection, deep brain stimulation (DBS) electrodes are stereotactically inserted. Electrophysiologic confirmation of electrodes position is accomplished by eliciting cortical recruiting responses and direct current (DC) shifts by low- and high-frequency stimulation through the electrodes. Cycling mode of bipolar stimulation has been used at 60-130 Hz, 0.45 msec, 2.5-3.5 V, 1 min ON in one side 4 min OFF, 1 min ON in the other side and 4 min OFF forward and back for 24h. ES of CMN significantly decreases generalized seizures of cortical origin and focal motor seizures. Best results are obtained in non-focal generalized tonic clonic seizures and atypical absences of the Lennox-Gastaut syndrome. Experience has indicated that the most effective target for seizure control is the thalamic parvocellular centromedian subnucleus.
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Authors | F Velasco, A L Velasco, M Velasco, F Jiménez, J D Carrillo-Ruiz, G Castro |
Journal | Acta neurochirurgica. Supplement
(Acta Neurochir Suppl)
Vol. 97
Issue Pt 2
Pg. 337-42
( 2007)
ISSN: 0065-1419 [Print] Austria |
PMID | 17691321
(Publication Type: Clinical Trial, Journal Article)
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Topics |
- Adolescent
- Adult
- Child
- Child, Preschool
- Deep Brain Stimulation
(methods)
- Electroencephalography
(methods)
- Epilepsy
(pathology, therapy)
- Female
- Humans
- Intralaminar Thalamic Nuclei
(physiopathology)
- Magnetic Resonance Imaging
(methods)
- Male
- Treatment Outcome
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