Post-ictal Rhythmic Thalamic Activity of the Centromedian Nucleus.

Autor:	Arredondo K; Department of Neurology, The University of Texas at Austin Dell Medical School, Austin, TX, U.S.A., Ostendorf AP; Division of Neurology, Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, U.S.A; and., Ahrens S; Division of Neurology, Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, U.S.A; and., Beatty CW; Division of Neurology, Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, U.S.A; and., Pindrik J; Division of Pediatric Neurosurgery, Department of Neurosurgery, Nationwide Children's Hospital, Columbus, OH, U.S.A., Shaikhouni A; Division of Pediatric Neurosurgery, Department of Neurosurgery, Nationwide Children's Hospital, Columbus, OH, U.S.A.
Jazyk:	angličtina
Zdroj:	Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society [J Clin Neurophysiol] 2024 May 01; Vol. 41 (4), pp. 326-333. Date of Electronic Publication: 2023 Mar 09.
DOI:	10.1097/WNP.0000000000000991
Abstrakt:	Introduction: Deep brain stimulation of the centromedian nucleus of the thalamus (CMN) to treat drug-resistant epilepsy has been of interest for decades. However, little is known about the electrophysiological activity of the CMN during seizures. We describe a novel CMN EEG finding associated with seizure: post-ictal rhythmic thalamic activity. Methods: Five patients with drug-resistant epilepsy of unknown etiology with focal onset seizures underwent stereoelectroencephalography monitoring as part of evaluation for potential resective surgery or neuromodulation. Two patients had previously undergone complete corpus callosotomy and vagus nerve stimulation. A standardized plan for implantation included targets in the bilateral CMN. Results: Each patient had frontal onset seizures, and two patients had additional insular, parietal, or mesial temporal onset seizures. Contacts of CMN were involved synchronously or rapidly after onset in most recorded seizures, particularly those with frontal onset. Focal onset hemiclonic and bilateral tonic-clonic seizures spread to involve cortical contacts with high-amplitude rhythmic spiking followed by abrupt offset with diffuse voltage attenuation. A post-ictal rhythmic 1.5 to 2.5 Hz delta frequency pattern, post-ictal rhythmic thalamic activity, emerged in CMN contacts amid the suppression of background activity in cortical contacts. In the two patients with corpus callosotomy, unilateral seizure spread and ipsilateral post-ictal rhythmic thalamic activity were observed. Conclusions: We observed post-ictal rhythmic thalamic activity in five patients with stereoelectroencephalography monitoring of the CMN with convulsive seizures. This rhythm appears late in ictal evolution and may signal an important role of the CMN in seizure termination. Furthermore, this rhythm may help identify CMN involvement in the epileptic network. Competing Interests: The authors have no funding or conflicts of interest to disclose. (Copyright © 2023 by the American Clinical Neurophysiology Society.)
Databáze:	MEDLINE
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