Motor cortex stimulation for facial chronic neuropathic pain: A review of the literature

Monsalve, Guillermo A.

doi:10.4103/2152-7806.103023

Cited by 57 publications

(49 citation statements)

References 117 publications

(195 reference statements)

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“…Intraoperative cortical stimulation triggers muscle spasms in the upper limb contra-laterally, which confirms the correctness of the position of the electrode. Electromyographic (EMG) stimulation is a routine method used to monitor the accuracy of the selected target [3][4][5][6][7][8][9]. In cases of phantom pain in an upper extremity, neighboring areas are localized, and electrodes are placed between the cortex for the lower extremity and the face.…”

Section: Discussionmentioning

confidence: 99%

“…Potential complications of MCS are mainly infections (5.7%), hardware-related problems (5.1%) and seizures; rarely, hematomas, speech disorders or paraesthesias may occur [5,12]. The complication rate is low, amounting to less than 10% [8].…”

Section: Discussionmentioning

confidence: 99%

“…In chronic neurogenic pain, a good response to MCS is observed in 55% of patients postoperatively, and in 45% after one year [12]. In neuropathic facial pain satisfactory improvement is observed in 84.7% of the patients [5]. Post-stroke thalamic pain is also a good indication, with a chance for pain alleviation in the majority of patients.…”

Section: Original Papersmentioning

confidence: 99%

“…Since Tsubokawa introduced MCS to treat central neurogenic pain, plenty of studies have proved the relative efficacy of this method [1][2][3][4][5][6][7][8][9]. Central pain is defined as the pain associated with a primary lesion of the central nervous system.…”

Section: Original Papersmentioning

confidence: 99%

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Motor Cortex Stimulation in Patients with Chronic Central Pain

Sokal¹,

Harat²,

Zieliński³

et al. 2015

Adv Clin Exp Med

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Background. Motor cortex stimulation is one of the neuromodulation methods of treating refractory central neurogenic pain. Objectives. The aim of this study was to retrospectively evaluate the effects of motor cortex stimulation. Material and Methods. The study group consisted of 14 consecutive patients with thalamic pain, atypical facial pain, post-brachial plexus avulsion injury pain, phantom pain and pain in syringomyelia who were treated with motor cortex stimulation at the Department of Neurosurgery of the Military Research Hospital in Bydgoszcz, Poland, from 2005 to 2013. The procedures were conducted with the use of neurosurgical navigation and intraoperative neurophysiological monitoring. The outcomes were assessed in terms of visual analog scale scores. The long-term follow-up ranged from one to six years. Results. A statistically significant reduction in the intensity of pain was noted in patients treated with motor cortex stimulation (pre-surgery median visual analog scale = 9, short-term result median visual analog scale = 3, p = 0.0009; long-term result median visual analog scale = 5, p = 0.0036). Over the long term, with follow-ups ranging from one to six years, the results were excellent (over 80% reduction in pain) in 31% of the patients and satisfactory (50-80% reduction in pain) in 23% of the patients. Unsatisfactory pain control (less than 50%) was noted in 31% of the patients and no improvement was noted in 15%. Significantly better relief of pain was observed in the early postoperative period. In this series of patients, the highest efficacy of motor cortex stimulation was observed in post-stroke or post-hemorrhagic thalamic pain (5/7 patients -71%). Long-term outcomes were not related to the age or sex of the patient, the preoperative duration of the pain, or to the position or number of implanted electrodes. Conclusions. MCS significantly reduces the intensity of neurogenic pain. The best long-term results in the present study were achieved in patients with thalamic syndrome. No significant predictors were found for a successful final outcome. The authors consider appropriate selection of patients, accurate placement of the electrodes and frequent adjusting of the stimulation parameters to be important factors increasing the efficacy of MCS (Adv Clin Exp Med 2015, 24, 2, 289-296).

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Original Papersmentioning

confidence: 99%

Section: Original Papersmentioning

confidence: 99%

See 2 more Smart Citations

Motor Cortex Stimulation in Patients with Chronic Central Pain

Sokal¹,

Harat²,

Zieliński³

et al. 2015

Adv Clin Exp Med

View full text Add to dashboard Cite

show abstract

“…Though it was first reported 46 in 1993 with 60-90% relief in pain intensity for trigeminal neuropathic pain (TNP) the true efficacy is highly controversial and is now only considered as one of the last resorts in the management options. Monsalve 47 evaluated the efficacy of MCS for facial chronic TNP in a systematic review and found that of 126 relevant studies and 118 patients, 100 (84.7%) underwent permanent implantation and 84% of those had good pain relief. Raslan et al 48 reported that 8 of 11 patients underwent permanent implantation and MCS for TNP and 5 continued to experience pain relief at a mean follow up of 33 months.…”

Section: B Sphenopalatine Ganglion Stimulation For Headache and Facimentioning

confidence: 99%