Takashi Takata1, Yoichi Katayama2, Takamitsu Yamamoto2, Teruyasu Hirayama2, S Koyama2
1Department of Neurological Surgery, Nihon University School of Medicine, Tokyo, Japan
2Department of Neuorological Surgery, Nihon University School of Medicine, Tokyo, Japan
Tóm tắt
All forms of therapy, including chronic stimulation of the thalamic relay nucleus, can provide satisfactory pain control in only 20%‐30% of cases of thalamic pain syndrome. In order to develop a more effective treatment for fhalamic pain syndrome, we investigated the effects of stimulation of various brain regions on the burst hyperactivity of thalamic neurons recorded in cats after deafferentiation of the spinothalamic pathway. Complete, long‐ term inhibition of the burst hyperactivity was induced by stimulation of the motor cortex, Based on this experimental finding, we treated seven cases of thalamic pain syndrome by chronic motor cortex stimulation employing epidural plate electrodes. Excellent or good pain control was obtained in all cases without any complications or side effects. During the stimulation, an increase in regional blood flow of the cerebral cortex and thalamus, a marked rise in temperature of the painful skin regions, and improved movements of the painful limbs were observed. These results suggest that thalamic pain syndrome can be most effectively treated by chronic motor cortex stimulation.
