Efficacy of Motor Cortex Stimulation for Intractable Central Neuropathic Pain: Comparison of Stimulation Parameters Between Post-stroke Pain and Other Central Pain
| Autor: | Toshihiko Wakabayashi, Shigenori Takebayashi, Satoshi Maesawa, Yasukazu Kajita, Hiroshi Noda, Daisuke Nakatsubo, Takafumi Tanei |
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| Rok vydání: | 2011 |
| Předmět: |
Male
medicine.medical_specialty Deep brain stimulation Visual analogue scale Deep Brain Stimulation medicine.medical_treatment Infarction Spinal Cord Diseases medicine Humans Aged Pain Measurement Retrospective Studies Referred pain business.industry Multiple sclerosis Motor Cortex Middle Aged medicine.disease Spinal cord Electrodes Implanted Pain Intractable Surgery Stroke medicine.anatomical_structure Anesthesia Neuropathic pain Neuralgia Thalamic hemorrhage Female Neurology (clinical) business |
| Zdroj: | Neurologia medico-chirurgica. 51:8-14 |
| ISSN: | 1349-8029 0470-8105 |
| DOI: | 10.2176/nmc.51.8 |
| Popis: | Motor cortex stimulation (MCS) has now become the preferred option for neurosurgical management of intractable central neuropathic pain such as post-stroke pain and trigeminal neuropathic pain. However, the efficacy of MCS for other central neuropathic pain such as pain resulting from spinal cord or brainstem lesions is unclear. We retrospectively reviewed 11 consecutive patients with intractable central neuropathic pain who underwent MCS in our institution. Eight patients had poststroke pain caused by thalamic hemorrhage (n = 5) or infarction (n = 3) (thalamic group). Two patients had postoperative neuropathic pain caused by spinal cord lesions, and one patient had facial pain caused by a brainstem lesion associated with multiple sclerosis (brainstem-spinal group). Visual analog scale and stimulation parameters were evaluated at 1 and 6 months postoperatively. MCS was effective for six of eight patients in the thalamic group, and all three patients in the brainstem-spinal group. These efficacies continued for 6 months after surgery without significant change in the stimulation parameters compared with the parameters at 1 month in both groups. The mean amplitude at 1 month and frequency at 6 months after surgery were significantly higher in the brainstem-spinal group than the thalamic group, although the patient number was small. MCS is effective for other central neuropathic pain, but higher intensity stimulation parameters may be necessary to gain adequate pain reduction. |
| Databáze: | OpenAIRE |
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