Pain Relief and Functional Recovery in Patients with Complex Regional Pain Syndrome after Motor Cortex Stimulation

2011 ◽  
Vol 89 (3) ◽  
pp. 167-172 ◽  
Author(s):  
Erich Talamoni Fonoff ◽  
Clement Hamani ◽  
Daniel Ciampi de Andrade ◽  
Lin Tchia Yeng ◽  
Marco Antonio Marcolin ◽  
...  
Keyword(s):  
Pain Relief ◽  
Motor Cortex ◽  
Complex Regional Pain Syndrome ◽  
Functional Recovery ◽  
Pain Syndrome ◽  
Motor Cortex Stimulation

Motor cortex stimulation in a patient with intractable complex regional pain syndrome Type II with hemibody involvement

2003 ◽  
Vol 98 (1) ◽  
pp. 175-179 ◽  
Author(s):  
Byung Chul Son ◽  
Moon Chan Kim ◽  
Dong Eon Moon ◽  
Joon Ki Kang
Keyword(s):  
Motor Cortex ◽  
Complex Regional Pain Syndrome ◽  
Pain Syndrome ◽  
Type Ii ◽  
Motor Cortex Stimulation ◽  
Functional Disturbance ◽  
Content Type ◽  
Subjective Sensation ◽  
Fine Print

✓ The authors describe the effectiveness of motor cortex stimulation (MCS) in a patient with complex regional pain syndrome (CRPS) Type II, formerly known as causalgia, with hemibody allodynia. During MCS, a subjective sensation of warm paresthesia developed in the painful hand and forearm and spread toward the trunk. Pain and allodynia in the areas associated with this sensation were alleviated significantly. The analgesic effect of stimulation proved to be long lasting and was still present at the 12-month follow up. The authors speculate that MCS might exert its effect through the modulation of thalamic activity in this particular case of CRPS with hemisensory deficit. A central mechanism associated with functional disturbance in noxious-event processing in the thalamus might have an important role in the pathogenesis of the condition.

scholarly journals Long-Term Results of a Simultaneous Trial of Deep Brain and Motor Cortex Stimulation in Refractory Neuropathic Pain

2017 ◽  
Vol 3 (1) ◽  
pp. 4-15
Author(s):  
Byung-chul Son ◽  
Jin-gyu Choi ◽  
Sang-woo Ha ◽  
Deog-ryeong Kim
Keyword(s):  
Neuropathic Pain ◽  
Pain Relief ◽  
Motor Cortex ◽  
Success Rate ◽  
Rating Scale ◽  
Long Term Results ◽  
Motor Cortex Stimulation ◽  
Significant Difference ◽  
Deep Brain

Objective Although deep brain stimulation (DBS) and motor cortex stimulation (MCS) are effective in patients with refractory neuropathic pain, their application is still empirical; there is no consensus on which technique is better. Methods To enhance the success rate of trial stimulation of invasive neuromodulation techniques and identify approapriate stimulation targets in individual patients, we performed a simultaneous trial of thalamic ventralis caudalis (Vc) DBS and MCS in 11 patients with chronic neuropathic pain and assessed the results of the trial stimulation and long-term analgesia. Results Of the 11 patients implanted with both DBS and MCS electrodes, nine (81.8%) had successful trials. Seven of these nine patients (77.8%) responded to MCS, and two (18.2%) responded to Vc DBS. With long-term follow-up (56 ± 27.5 months), the mean numerical rating scale decreased significantly (P < 0.05). The degree of percentage pain relief in the chronic MCS (n = 7) and chronic DBS (n = 2) groups were 34.1% ± 18.2% and 37.5%, respectively, and there was no significant difference (P = 0.807). Five out of the seven MCS patients (71%) and both DBS patients had long-term success with the treatments, defined as >30% pain relief compared with baseline. Conclusions With simultaneous trial of DBS and MCS, we could enhance the success rate of invasive trials. Considering the initial success rate and the less invasive nature of epidural MCS over DBS, we suggest that MCS may be a better, initial means of treatment in chronic intractable neuropathic pain. Further investigations including other subcortical target-associated medial pain pathways are warranted.

1 Patients with Complex Regional Pain Syndrome type I and fixed posture of the hand disclose a normal motor cortex plasticity

Basal Ganglia ◽  
2012 ◽  
Vol 2 (4) ◽  
pp. 257
Author(s):  
C. Terranova ◽  
A. Naro ◽  
M. Russo ◽  
V. Rizzo ◽  
G. Risitano ◽  
...  
Keyword(s):  
Motor Cortex ◽  
Complex Regional Pain Syndrome ◽  
Pain Syndrome ◽  
Type I ◽  
Syndrome Type ◽  
Motor Cortex Plasticity

scholarly journals Pulsed Radiofrequency Treatment of Complex Regional Pain Syndrome: A Case Series

2014 ◽  
Vol 19 (4) ◽  
pp. 186-190 ◽  
Author(s):  
Vlad Djuric
Keyword(s):  
Pain Relief ◽  
Lower Extremity ◽  
Effective Treatment ◽  
Complex Regional Pain Syndrome ◽  
Present Report ◽  
Case Series ◽  
Pain Syndrome ◽  
Sympathetic Chain ◽  
Type I ◽  
Pulsed Radiofrequency

BACKGROUND: Various forms of sympathetic chain neurolysis (sympathectomy) have, at one time or another, held promise as effective treatment options for complex regional pain syndrome (CRPS). Complications, such as worsening pain and the development of new pain syndromes, have prevented sympathectomy from emerging as a standard intervention. In an effort to avoid poor outcomes associated with neurolysis, pulsed radiofrequency (PRF) has been proposed as a potential treatment alternative for a number of chronic neuropathic pain states, including some forms of CRPS.METHODS: The present report describes three cases in which patients diagnosed with lower extremity CRPS type I obtained substantial and lasting intervals of pain relief following PRF of the lumbar sympathetic chain. Over a period of four years, 14 fluoroscopically guided procedures using PRF lesioning of the lumbar sympathetic chain at L2, L3 and L4 were performed in three individuals with CRPS type I of the lower limb. Outcome measures included pre- and post-treatment self-reported pain and medication requirements.RESULTS: Substantial pain relief (>50%) was achieved in 91.7% of PRF applications at three months and 83.3% at six months, with some treatments resulting in persistent relief well beyond 12 months. Medication use decreased to a comparable degree, with discontinuation of opiates after all but three treatments.CONCLUSIONS: PRF lesioning of the lumbar sympathetic chain can be an effective treatment for patients with CRPS type I of the lower extremity, with the potential to provide ≥6 months of substantial pain relief.

Sign in / Sign up

Export Citation Format

Share Document