Stereotactic Lesions of the Pulvinar for Hypertonus and Dyskinesias
This paper is concerned with clinical neurophysiological and histochemical correlative studies on the effect of lesions of the superior pulvinar in the course of treatment of hypertonus and some of the dyskinesias. We have in fact a twenty year study of the superior pulvinar but the first seventeen years of this were accidental. The posterior 15 mm parasagittal track which Guiot and Gillingham decided to use from 1955 led us through the superior part of the pulvinar en route for the areas of v.o.p. and v.o.a. or the thalamus, capsule and pallidum. Nevertheless we do have records to which we can look back with some interest although in the earlier cases accuracy of target siting is inevitably in question before the routine use of depth microelectrode recording in 1963. After crossing the posterior horn of the lateral ventricle the microelectrode began immediately to record cell activity after piercing the ependyma overlying the pulvinar. There was a distinctive pattern of amplitude which was relatively lower than that of the sensory relay nucleus lying anterior to it (Fig. 1). Entering the sensory relay nucleus led to a sudden rise of amplitude which was immediately shown both on the oscillograph but even better from the loudspeaker on auditory monitoring. Within a millimetre evoked responses were obtained from the hand, fingers or face, usually at first of the pressure or joint displacement type.
KeywordsMultiple Sclerosis Involuntary Movement Posterior Horn Intention Tremor Parkinsonian Tremor
Unable to display preview. Download preview PDF.
- Gillingham, F. J., Tsukamoto, Y., Walsh, E. G. (1973), Treatment of rigidity. In: Parkinson’s Disease (Siegfried, J., ed.), Vol. 1: Lead of Statement, pp. 94–114. Bern-Stuttgart-Vienna: H. Huber.Google Scholar