Motor cortex stimulation for deafferentation pain
| Autor: | Toshiki Yoshimine, Youichi Saitoh, Shun-ichiro Hirano, Haruhiko Kishima, Amami Kato, Masayuki Hirata, Kazumi Yamamoto |
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| Rok vydání: | 2001 |
| Předmět: |
Male
Causalgia medicine.medical_specialty Lidocaine Electric Stimulation Therapy Neuropsychological Tests medicine Humans Ketamine Subdural space Electrodes Spinal cord injury Aged Pain Measurement Retrospective Studies Analgesics Referred pain Motor Cortex General Medicine Middle Aged medicine.disease Central sulcus Surgery Treatment Outcome medicine.anatomical_structure Brachial plexus injury Anesthesia Morphine Female Neurology (clinical) Psychology medicine.drug |
| Zdroj: | Scopus-Elsevier |
| ISSN: | 1092-0684 |
| DOI: | 10.3171/foc.2001.11.3.2 |
| Popis: | Object The authors tested a modified motor cortex stimulation (MCS) protocol for the treatment of deafferentation pain in 15 patients: eight patients with poststroke pain, four with brachial plexus injury, two with phantom limb pain, and one with spinal cord injury. Methods Preoperative pharmacological tests were performed with phentolamine, lidocaine, ketamine, thiopental, morphine, and a placebo. In 12 patients we placed a 20– or 40–grid electrode in the subdural space to determine the best stimulation point for pain relief over a few weeks and therefore the optimum position for a permanent internal device. In four patients, the MCS devices were implanted in the interhemispheric fissure to reduce lower-extremity pain. In one patient, the MCS device was placed within the central sulcus, and a 20-grid electrode was placed on the brain surface. In two patients with pain extending from the upper extremity to the hyperbody, dual-electrode devices were implanted to drive two electrodes. In 10 of the 15 patients MCS-induced pain reduction was achieved (four with excellent, two with good, and four with fair alleviation of pain). The result of pharmacological testing indicated that patients with ketamine sensitivity seem to be good candidates for MCS. Conclusions Test stimulation with a subdural multigrid electrode was helpful in locating the best stimulation point for pain relief. |
| Databáze: | OpenAIRE |
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