Velasco F, Velasco M, Márquez I, Velasco G
Unit of Neurology, General Hospital, SSA, Mexico City, Mexico.
Acta Neurochir Suppl (Wien). 1993;58:201-4. doi: 10.1007/978-3-7091-9297-9_48.
Twenty-eight patients underwent electrical stimulation of the centromedian (CM) thalamic nucleus as a neuro-augmentative procedure to control intractable seizures of various types. To assess the correct placement of electrodes, electrical stimulation at 3 and 6 Hz, 1.0 msec and 600-2000 uA pulses in trains of 30-60 sec were used while the EEG was recorded by scalp electrodes. Spontaneous seizure activities of various types were simultaneously recorded. In cases of focal epilepsy depth electrodes were used in order to study the sequence of activation of different structures. Three Hz electrical stimulation induced spike-and-wave complexes accompanied by a typical absence. Eight Hz induced recruiting-like responses with ipsilateral predominance and no clinical manifestations. Interictal spike activity was recorded in the CM in cases of generalized tonic-clonic convulsions (GTCC) and ictal spike pattern in the CM preceded discharges in other areas. In atypical absences cortical and CM discharges occurred simultaneously. It is concluded that the CM participates in the onset of GTCC and typical absences, in the propagation of secondary GTCC but not in myoclonic convulsions.
28名患者接受了丘脑中央中核（CM）电刺激，作为一种神经增强手术来控制各种类型的顽固性癫痫发作。为评估电极的正确放置，在通过头皮电极记录脑电图时，使用3和6Hz、1.0毫秒、600 - 2000微安脉冲、持续30 - 60秒的电刺激序列。同时记录各种类型的自发性癫痫活动。对于局灶性癫痫，使用深部电极以研究不同结构的激活顺序。3Hz电刺激诱发棘慢复合波并伴有典型失神发作。8Hz电刺激诱发同侧优势的募集样反应且无临床表现。在全身性强直阵挛性惊厥（GTCC）患者中，在CM记录到发作间期棘波活动，在CM的发作期棘波模式先于其他区域放电。在非典型失神发作中，皮质和CM放电同时发生。结论是，CM参与GTCC和典型失神发作的起始，参与继发性GTCC的传播，但不参与肌阵挛性惊厥。
