PMC8113700_01
Bilateral RNS CMN implantation. (A) Direct targeting of the bilateral CMN (crosses) in AC-PC orientation. (B) Post-implant x-ray of RNS system. (C) Coronal 3D reconstruction of bilateral RNS implantation targeting the CMN (blue), in relation to the posterior part of the ventral posterolateral nucleus (VPLp; red) and posterior dorsal part of the ventral lateral nucleus (VLpd; purple).
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The Thalamus Atlas, see Figure 1. The patient recovered and was discharged home on postoperative day 1.
Electrophysiological seizure characteristics. (A) Example of an electroclinical seizure stored the NeuroPace Patient Data Management System, detected by device (A1) and noted by patient's family with magnet swipe (M). Well-formed 3 Hz spike-and-wave discharges are detected maximally in channels 1 (LCM1-LCM2; top row) and 3 (RCM1-RCM2; third row). (B) Spectrogram of identical epoch. (C) Pre-implantation scalp EEG, capturing electroclinical typical absence seizure (TAS) with behavioral arrest. EEG demonstrates generalized 3 Hz spike- and polyspike-and-wave discharges (longitudinal bipolar montage; sensitivity: 30 muV/mm; timebase 30 mm/s). (D) Example of an electroclinical seizure stored the NeuroPace Patient Data Management System, detected by device (A1, A2) again detected maximally in channels 1 and 3, with responsive therapy delivered (Tx), subsequent amplifier artifact lasting 5 s, and return to electrographic baseline. Therapy delivered to channels 1 and 3: bipolar, current 0.4 mA, frequency 125 Hz, pulse width 160 mus, burst duration 5,000 ms, charge density 0.4 muC/cm2. (E) Spectrogram of identical epoch.
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Review of saved ECoG in the Patient Data Management System (PDMS) revealed well-formed 3 Hz spike-wave discharges in the bilateral thalamic contacts, with highest amplitudes in the distal contacts bilaterally (Figure 2).
Electrophysiological characteristics of prolonged absence and GTC seizures. (A) Example of an electroclinical generalized tonic clonic (GTC) seizure stored the NeuroPace Patient Data Management System, detected by device (A1, A2) and noted by patient's family with magnet swipe (M), with responsive therapy delivered (Tx). (B) Example of a prolonged electroclinical absence seizure stored the NeuroPace Patient Data Management System, detected by device (A1, A2) and noted by patient's family with magnet swipe (M), with responsive therapy delivered (Tx).
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Additionally, ECOG recordings captured prolonged absence seizure and generalized tonic-clonic seizure activity, see Figure 3.