Anterior thalamus (ANT) deep-brain stimulation (DBS) is an approved therapy for drug
resistant epilepsy. We aimed to identify interictal epileptiform discharges (IED)
in the ANT and to investigate their relationship with surface IEDs. Fifteen patients
were monitored for two consecutive nights with externalized thalamic leads to analyze
the intrathalamic epileptiform activities (TIED). Forty-six % of all contacts were
located within the ANT. We found that all the responders had TIEDs within the ANT,
while this held true only for 44% of the non-responders. The overall response rate
(RR) at 1-year follow-up was 40%, while it was 44% in bilateral ANT hit patients and
45% in epileptic focus side hit. However, in case of TIEDs present in the focus side
the RR reached as high as 71%. TIED activity may prove the pathophysiological connection
to the seizure focus, and stimulation of this area might have a better suppressing
effect on seizures.
