Pulvinar nuclei [Neurosurgery Wiki]

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====== Pulvinar nuclei ======

{{ ::pulvinar.png?400|}}

The pulvinar [[nuclei]] or nuclei of the [[pulvinar]] (nuclei pulvinares) are the [[nuclei]] located in the [[thalamus]].

As a group they make up the collection called the pulvinar of the thalamus (pulvinar thalami), usually just called the [[pulvinar]].
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The [[pulvinar]] has remained largely unstudied as a [[neurostimulation]] target to treat [[refractory epilepsy]]. Because the pulvinar has connections with the [[posterior quadrant]], neurostimulation may be effective if applied to [[seizure]]s originating in this area. Burdette et al. performed a retrospective [[chart review]] of patients with regional [[neocortical epilepsy]] onsets in the posterior quadrant treated with [[Responsive neurostimulation]]. [[Demographics]], epilepsy history, clinical seizure frequencies, and [[neuropsychological test]]ing results were obtained from the [[chart]]. [[Electrocorticogram]] (ECoG) records stored by the [[RNS]] System were reviewed to evaluate electrographic seizure onset patterns. The patients were followed for 10, 12.5, and 15 months. All patients were responders (≥50% seizure reduction), and two of the three patients experienced a ≥90% reduction in seizures at the last follow-up. Pre- and postsurgical neuropsychological evaluations were compared for two of the patients, and there was no evidence of cognitive decline found in either patient. Interestingly, mild [[cognitive]] improvements were reported. The third patient had only postimplant neuropsychological testing data available. Findings for this patient suggested [[executive dysfunction]] that was present prior to the RNS System which did not worsen with surgery. A visual inspection of ECoGs revealed near-simultaneous seizure onsets in neocortical and pulvinar leads in two patients. Seizure onsets in the third patient were more variable. This is the first published report of brain-responsive neurostimulation targeting the [[pulvinar]] to treat refractory regional onset epilepsy of posterior quadrant origin
((Burdette D, Mirro EA, Lawrence M, Patra SE. Brain-responsive corticothalamic stimulation in the pulvinar nucleus for the treatment of regional neocortical epilepsy: A case series. Epilepsia Open. 2021 Sep;6(3):611-617. doi: 10.1002/epi4.12524. Epub 2021 Aug 3. PMID: 34268893; PMCID: PMC8408587.)).