title: Centromedian thalamic nuclei deep brain stimulation in refractory status epilepticus.
abstract: BACKGROUND
  Refractory status epilepticus (RSE) is associated with high mortality. We report a potential treatment alternative.
  
  
  OBJECTIVE
  Deep brain stimulation (DBS) of the centromedian thalamic nuclei (CMN) can be effective in the treatment of RSE.
  
  
  METHODS
  Report of the evolution of RSE after DBS of the CMN in a 27-year-old man.
  
  
  RESULTS
  In the course of an encephalopathy of unknown origin, and after a cardiac arrest, the patient developed RSE with myoclonic jerks and generalized tonic-clonic seizures. The EEG showed continuous generalized periodic epileptiform discharges (GPEDS). Five weeks after RSE onset, bilateral DBS of the CMN was started. This treatment was immediately followed by disappearance of tonic-clonic seizures and GPEDS, suggesting a resolution of RSE. The patient continued having multifocal myoclonic jerks, probably subcortical in origin, which resolved after 4 weeks. The patient remained clinically stable for 2 months in a persistent vegetative state.
  
  
  CONCLUSIONS
  The remission of RSE, the abolition of GPEDS, and the patient survival suggest that DBS of the CMN may be efficacious in the treatment of refractory, generalized status epilepticus.
authors.affiliation: Department of Clinical Neuroscience, Institute of Psychiatry, King's College London, London, United Kingdom. antonio.valentin@kcl.ac.uk
authors.forename: Antonio
authors.initials: A
authors.lastname: Valentín
authors.forename: Huy Q
authors.initials: HQ
authors.lastname: Nguyen
authors.forename: Alena M
authors.initials: AM
authors.lastname: Skupenova
authors.forename: Zaloa
authors.initials: Z
authors.lastname: Agirre-Arrizubieta
authors.forename: Sharon
authors.initials: S
authors.lastname: Jewell
authors.forename: Nandini
authors.initials: N
authors.lastname: Mullatti
authors.forename: Nicholas F
authors.initials: NF
authors.lastname: Moran
authors.forename: Mark P
authors.initials: MP
authors.lastname: Richardson
authors.forename: Richard P
authors.initials: RP
authors.lastname: Selway
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Alarcón
mesh_terms: D000328:Adult; D046690:Deep Brain Stimulation / Q000379:methods*; D006801:Humans; D020646:Intralaminar Thalamic Nuclei / Q000503:physiopathology*; D008297:Male; D013226:Status Epilepticus / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome