Klinische Neurophysiologie 2014; 45 - P32
DOI: 10.1055/s-0034-1371245

Ictal local field potential recordings in nucleus subthalamicus (STN) in a patient with idiopathic generalized epilepsy (IGE)

FC Schmitt 1, L Büntjen 2, F Marquardt 1, S Rampp 3, H Stefan 3, M Holtkamp 4, J Voges 2, HJ Heinze 1, C Kluge 1
  • 1O.-v.-Guericke University, Dpt. of Neurology, Magdeburg, Deutschland
  • 2O.-v.-Guericke University, Dpt. of Stereotactic Neurosurgery, Magdeburg, Deutschland
  • 3University Hospital Erlangen, Department of Neurology, Epilepsy Center, Erlangen, Deutschland
  • 4Charité – Universitätsmedizin, Epilepsy-Center Berlin-Brandenburg, Berlin, Deutschland

Rationale: For more than a decade STN has been discussed as a potential target for deep brain stimulation (DBS) and ictal recordings have been obtained in focal epilepsies (e.g. Loddenkemper et al., Journal of Clinical Neurophysiology, 2001). Recently, DBS of STN showed a beneficial effect in progressive myoclonus epilepsy, an epilepsy syndrome with a distinct seizure type: generalized myoclonic seizures (Vesper et al. Epilepsia 2007). Ictal field recordings from the STN were recorded simultaneously with surface electrodes in a patient with pharmacoresistant IGE.

Methods: We report the case history of a STN-DBS treated 55 year-old male with IGE, which has been responsive the pharmacological treatment with the exception to severly disabling generalized myoclonic seizures. The main analysis method was directional phase locking, which was supplemented through directed transfer entropy analyses, another measure of information exchange between network nodes.

Results: We were able to trace the synchronization in the network sampled and found that epileptic activity occurred first in the STN and then progressed to the other parts of the brain, including the contralateral hemisphere. During the seizures beta-activity in the STN was modulated in a complex fashion, and this modulation affected the entire network.

Conclusions: Our analyses demonstrate a potential pathophysiological involvement of the STN by synchronization as the seizure develops. They provide a further step in understanding the pathophysiological mechanisms of myoclonic seizures in IGE.