Neurones with epileptiform discharge in the central nervous system and chronic pain. Experimental and clinical investigations.

Epileptiform discharge was recorded from neurons in the thalamic nuclei of chronic pain patients during stereotactic surgery. Hyperactive neurons showed regular firing of 3-5 trains of epileptic-like group discharges with a frequency of 4 to 5 Hz. As described by Lombard et al. (1979), we operated on the dorsal root unilaterally, sectioning C5 to Thl in male Wistar rats. One to three months after the operation, hyperactive neurons were examined in the contra-lateral thalamic nuclei (VP, zona incerta), and lemniscus medialis. The firing patterns and distribution of hyperactive neurons in these animals was very similar to those of humans. The hyperactive neuron was unaffected by electrical stimulation of the nucleus raphe dorsalis (NRD) and locus ceruleus (LC). Administration of phenytoin and diazepam reduced the firing. However, no effect was seen with valproic acid. During spreading depression of the sensorimotor cortex, a remarkable reduction was seen on the firing of thalamic hyperactive neurons. This suggested that hyperactive neurons of the thalamic nuclei received facilitory effects from the sensorimotor cortex with little influence from adrenergic or serotoenergic systems.