Refractory Status Epilepticus Treated With Bilateral Pulvinar Deep Brain Stimulation—A Case Study
New-onset refractory status epilepticus (NORSE) arises without an identifiable cause or prior epilepsy history, with a 16%-27% mortality rate and significant long-term neurological sequelae. Neuromodulation such as deep brain stimulation (DBS) targeting the anterior and centromedian thalamic nuclei has shown promise when the traditional approach of anti-seizure medications (ASMs), anesthetics, and immunomodulation fails. We present a case of cryptogenic NORSE in a 30-year-old male with autism and developmental delay, with refractory seizures localized to bilateral posterior quadrants. Sensing-enabled DBS targeting the pulvinar thalami led to decreased seizure burden and clinical improvement, highlighting the importance of tailoring neuromodulatory targets to seizure localization.
Authors
- Anant Naik (ORCID: https://orcid.org/0000-0002-7491-5401)
- Ilo E. Leppik (ORCID: https://orcid.org/0000-0001-7825-9299)
- Sandipan Pati (ORCID: https://orcid.org/0000-0002-9578-2820)
- Robert A. McGovern (ORCID: https://orcid.org/0000-0003-0752-1899)
- Mengxuan Tang (ORCID: https://orcid.org/0000-0002-1030-1988)
- Sima Patel (ORCID: https://orcid.org/0000-0002-3788-3439)
- Mana Shams (ORCID: https://orcid.org/0009-0003-9066-6470)
- Théoden I. Netoff (ORCID: https://orcid.org/0000-0002-0115-1930)
- Zhiyi Sha (ORCID: https://orcid.org/0000-0003-4749-993X)
- Thaddeus S. Walczak
- Thomas R. Henry (ORCID: https://orcid.org/0000-0002-5708-903X)
- Zachary Sanger (ORCID: https://orcid.org/0000-0003-2144-1895)
- Benjamin Miller (ORCID: https://orcid.org/0000-0001-9988-9687)
- Thomas Lisko
- Filomena Ferreira (ORCID: https://orcid.org/0000-0002-0519-1753)
- Amerta Bai (ORCID: https://orcid.org/0009-0006-9087-3906)
- Oladi Bentho
Institutions
- University of Minnesota (US)
- University of Minnesota Medical Center (US)
Publication Details
- Journal
- Annals of Clinical and Translational Neurology
- Published
- 2025-12-04
- DOI
- https://doi.org/10.1002/acn3.70268
- Primary Topic
- Neurological disorders and treatments
- Type
- article
- Field-Weighted Citation Impact
- 0.00