open access

Vol 46, No 5 (2012)
ARTYKUŁ ORYGINALNY
Submitted: 2010-11-30
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Motor cortex stimulation in the treatment of neuropathic pain

Tomasz Mandat, Henryk Koziara, Sławomir Barszcz, Rafał Rola, Michał Karliński, Anna Śliwińska, Stephane Palfi, Radosław Michalik, Artur Oziębło, Jacek Kunicki, Paweł Nauman, Wiesław Bonicki
DOI: 10.5114/ninp.2012.31352
·
Neurol Neurochir Pol 2012;46(5):428-435.

open access

Vol 46, No 5 (2012)
ARTYKUŁ ORYGINALNY
Submitted: 2010-11-30

Abstract

Background and purpose

Despite the rapid development of neuropharmacotherapy, medical treatment of neuropathic pain (NP) still constitutes a significant socioeconomic problem. The authors herein present a group of patients treated with motor cortex stimulation (MCS) for NP of various types and aetiologies.

Material and methods

Our cohort included 12 female and 11 male NP patients aged 53 ± 16 treated with MCS. Eleven patients were diagnosed with neuropathic facial pain (NFP), 8 with hemi-body neuropathic pain (HNP), and 4 with deafferentation pain (DP). Prior to surgery, 16 out of 23 patients were treated with repetitive transcranial magnetic stimulation (rTMS), with a positive response in 10 cases. Pain intensity in our group was evaluated with the visual analogue scale (VAS) one month before and three months after MCS implantation.

Results

Improvement on the VAS was reported in the whole group of patients (p < 0.001). The best results were reported in the NFP group (p < 0.001) while the worst ones were noted in the DP group (p = 0.04). Anamnesis duration positively correlated with outcome. Infection forced the authors to permanently remove the system in one case. There were no other complications in the group.

Conclusions

Minimally invasive, safe neuromodulative treatment with MCS permits neuropathic pain control with good efficacy. The type of neuropathic pain might be a prognostic factor.

Abstract

Background and purpose

Despite the rapid development of neuropharmacotherapy, medical treatment of neuropathic pain (NP) still constitutes a significant socioeconomic problem. The authors herein present a group of patients treated with motor cortex stimulation (MCS) for NP of various types and aetiologies.

Material and methods

Our cohort included 12 female and 11 male NP patients aged 53 ± 16 treated with MCS. Eleven patients were diagnosed with neuropathic facial pain (NFP), 8 with hemi-body neuropathic pain (HNP), and 4 with deafferentation pain (DP). Prior to surgery, 16 out of 23 patients were treated with repetitive transcranial magnetic stimulation (rTMS), with a positive response in 10 cases. Pain intensity in our group was evaluated with the visual analogue scale (VAS) one month before and three months after MCS implantation.

Results

Improvement on the VAS was reported in the whole group of patients (p < 0.001). The best results were reported in the NFP group (p < 0.001) while the worst ones were noted in the DP group (p = 0.04). Anamnesis duration positively correlated with outcome. Infection forced the authors to permanently remove the system in one case. There were no other complications in the group.

Conclusions

Minimally invasive, safe neuromodulative treatment with MCS permits neuropathic pain control with good efficacy. The type of neuropathic pain might be a prognostic factor.

Get Citation

Keywords

neuropathic pain, cortical stimulation, transcranial magnetic stimulation

About this article
Title

Motor cortex stimulation in the treatment of neuropathic pain

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 46, No 5 (2012)

Pages

428-435

DOI

10.5114/ninp.2012.31352

Bibliographic record

Neurol Neurochir Pol 2012;46(5):428-435.

Keywords

neuropathic pain
cortical stimulation
transcranial magnetic stimulation

Authors

Tomasz Mandat
Henryk Koziara
Sławomir Barszcz
Rafał Rola
Michał Karliński
Anna Śliwińska
Stephane Palfi
Radosław Michalik
Artur Oziębło
Jacek Kunicki
Paweł Nauman
Wiesław Bonicki

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