Thalamocortical dysrhythmia II. Clinical and surgical aspects

D. Jeanmonod, M. Magnin, A. Morel, M. Siegemund, A. Cancro, M. Lanz, R. Llinás, U. Ribary, E. Kronberg, J. Schulman, M. Zonenshayn

The companion paper (Llinás et al., 2001) presents evidence, at both cellular and network levels, for the role of resonant oscillatory thalamocortical properties in normal and pathological brain function. Here we present confirmatory single cell electrophysiology from the thalami of thalamocortical dysrhythmia (TCD) patients and review our surgical approach towards the relief of this chronic disabling condition, in its many forms. The goal of surgery is a rebalancing of the abnormal thalamocortical oscillation responsible for TCD. Our approach uses small strategically placed pre-thalamic and medial thalamic lesions that serve to make subcritical the low frequency thalamocortical reentry network attractor via desinhibition and desamplification. The lesions address classical and new stereotactic targets that provide therapeutic efficiency coupled with the sparing of the specific thalamocortical loops.
© 2001 Elsevier Science Ltd. All rights reserved.
Thalamus & Related Systems 1 (2001) 245–254
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