Reply: On the Role of Medial Pulvinar Thalamic (PuM) Nucleus in Temporal Lobe Epilepsy

Abstract

Sir, We thank Prof. Mauguiere for his comments concerning our article recently published in Brain (Guye et al ., 2006). Our article follows previous works from our group studying the interdependencies between signals from several regions of the brain during partial seizures (Bartolomei et al ., 1999; 2002; 2004; Wendling et al ., 2003). The main objective of these works was to anatomically and functionally define the networks that generate seizures and/or are involved in seizure propagation. Patients included in this study mainly presented with anteromesial temporal lobe epilepsy (10) and three had lateral temporal lobe epilepsy (TLE). We described a gradual synchronization between the temporal lobe and the thalamus (mainly PuM) that was particularly marked in mesial TLE seizures. In addition some patients had early synchronization of thalamic and temporal lobe signals. One of the main findings of our study was to correlate the degree of thalamocortical synchrony and ictal loss of consciousness, a finding confirming previous hypotheses about the mechanisms of consciousness alteration in TLE (Blumenfeld et al ., 2004). In the following we will discuss four points/concerns raised by F. Mauguiere