BACKGROUND: Motor cortex stimulation has been proposed for the treatment of central pain. METHODS: Thirty-two patients with refractory central and neuropathic pain of peripheral origin were treated by chronic stimulation of the motor cortex between May 1993 and January 1997. The mean follow-up was 27.3 months. The first 24 patients were operated on according to the technique described by Tsubokawa. The last 13 cases (8 new patients and 5 reinterventions) were operated on by a technique including localization by superficial CT reconstruction of the central region and neuronavigator guidance. The position of the central sulcus was confirmed by the use of intraoperative somatosensory evoked potentials. The somatotopic organization of the motor cortex was established preoperatively by studying the motor responses at stimulation of the motor cortex through the dura. RESULTS: Ten of the 13 patients with central pain (77%) and 10 of the 12 patients with neuropathic facial pain experienced substantial pain relief (83.3%). One of the three patients with post-paraplegia pain was clearly improved. A satisfactory result was obtained in one patient with pain related to plexus avulsion and in one patient with pain related to intercostal herpes zoster. None of the patients developed epileptic seizures. CONCLUSIONS: Our results confirm that chronic stimulation of the motor cortex is an effective method in treating certain forms of refractory pain.
BACKGROUND: Motor cortex stimulation has been proposed for the treatment of central pain. METHODS: Thirty-two patients with refractory central and neuropathic pain of peripheral origin were treated by chronic stimulation of the motor cortex between May 1993 and January 1997. The mean follow-up was 27.3 months. The first 24 patients were operated on according to the technique described by Tsubokawa. The last 13 cases (8 new patients and 5 reinterventions) were operated on by a technique including localization by superficial CT reconstruction of the central region and neuronavigator guidance. The position of the central sulcus was confirmed by the use of intraoperative somatosensory evoked potentials. The somatotopic organization of the motor cortex was established preoperatively by studying the motor responses at stimulation of the motor cortex through the dura. RESULTS: Ten of the 13 patients with central pain (77%) and 10 of the 12 patients with neuropathic facial pain experienced substantial pain relief (83.3%). One of the three patients with post-paraplegia pain was clearly improved. A satisfactory result was obtained in one patient with pain related to plexus avulsion and in one patient with pain related to intercostal herpes zoster. None of the patients developed epilepticseizures. CONCLUSIONS: Our results confirm that chronic stimulation of the motor cortex is an effective method in treating certain forms of refractory pain.
Authors: Raghavan Gopalakrishnan; Richard C Burgess; Scott F Lempka; John T Gale; Darlene P Floden; Andre G Machado Journal: J Neurophysiol Date: 2016-06-29 Impact factor: 2.714
Authors: Benoit Pirotte; Carine Neugroschl; Thierry Metens; David Wikler; Vincent Denolin; Philippe Voordecker; Alfred Joffroy; Nicolas Massager; Jacques Brotchi; Marc Levivier; Danielle Baleriaux Journal: AJNR Am J Neuroradiol Date: 2005-10 Impact factor: 3.825
Authors: Ziad Nahas; Berry S Anderson; Jeff Borckardt; Ashley B Arana; Mark S George; Scott T Reeves; Istvan Takacs Journal: Biol Psychiatry Date: 2010-01-15 Impact factor: 13.382
Authors: Magdalena Sarah Volz; Theresa Sophie Volz; Andre Russowsky Brunoni; João Paulo Vaz Tostes Ribeiro de Oliveira; Felipe Fregni Journal: Neuromodulation Date: 2012-07-03