scholarly journals Motor Cortex Stimulation for Intractable Neuropathic Facial Pain Related to Multiple Sclerosis

2010 ◽  
Vol 50 (7) ◽  
pp. 604-607 ◽  
Author(s):  
Takafumi TANEI ◽  
Yasukazu KAJITA ◽  
Toshihiko WAKABAYASHI
Keyword(s):  
Multiple Sclerosis ◽  
Motor Cortex ◽  
Facial Pain ◽  
Motor Cortex Stimulation

Motor cortex stimulation: functional magnetic resonance imaging–localized treatment for three sources of intractable facial pain

2011 ◽  
Vol 114 (1) ◽  
pp. 189-195 ◽  
Author(s):  
Darian R. Esfahani ◽  
Marc T. Pisansky ◽  
Rima M. Dafer ◽  
Douglas E. Anderson
Keyword(s):  
Motor Cortex ◽  
Facial Pain ◽  
Precentral Gyrus ◽  
Motor Cortex Stimulation ◽  
Electrode Implantation ◽  
Deafferentation Pain ◽  
Functional Mr Imaging ◽  
Incisional Pain ◽  
Narrative Report ◽  
Localized Treatment

Neuropathic facial pain can be a debilitating condition characterized by stabbing, burning, dysesthetic sensation. With a large range of causes and types, including deafferentation, postherpetic, atypical, and idiopathic, both medicine and neurosurgery have struggled to find effective treatments that address this broad spectrum of facial pain. The authors report the use of motor cortex stimulation to alleviate 3 distinct conditions associated with intractable facial pain: trigeminal deafferentation pain following rhizotomy, deafferentation pain secondary to meningioma, and postherpetic neuralgia. Functional MR imaging was used to localize facial areas on the precentral gyrus prior to surgery. All 3 patients experienced long-lasting complete or near-complete resolution of pain following electrode implantation. Efficacy in pain reduction was achieved through variation of stimulation settings over the course of treatment, and it was assessed using the visual analog scale and narrative report. Surgical complications included moderate postsurgical incisional pain, transient cerebral edema, and intraoperative seizure. The authors' results affirm the efficacy and broaden the application of motor cortex stimulation to several forms of intractable facial pain.

DYSPHAGIA AND NEUROPATHIC FACIAL PAIN TREATED WITH MOTOR CORTEX STIMULATION

Neurosurgery ◽  
2009 ◽  
Vol 65 (3) ◽  
pp. E626-E626 ◽  
Author(s):  
William S. Anderson ◽  
Satoshi Kiyofuji ◽  
James E. Conway ◽  
Chris Busch ◽  
Richard B. North ◽  
...  
Keyword(s):  
Motor Cortex ◽  
Facial Pain ◽  
Symptom Relief ◽  
Pain Syndrome ◽  
Symptom Improvement ◽  
Motor Cortex Stimulation ◽  
Percutaneous Procedures ◽  
Oral Pain ◽  
History Of

Abstract OBJECTIVE We report on a patient with a neuropathic facial pain syndrome, including elements of trigeminal neuralgia, glossopharyngeal neuralgia, and dysphagia. After failing medical and surgical decompressive treatments, the patient underwent implantation of a motor cortex stimulation (MCS) system. CLINICAL PRESENTATION A 54-year-old woman presented with a 14-year history of left-sided facial pain, throat pain, and associated nausea and vomiting. The patient failed several open surgical and percutaneous procedures for her facial pain syndrome. Additionally, several medication trial attempts were unsuccessful. Imaging studies were normal. INTERVENTION The patient underwent placement of a right-sided MCS system for treatment of her neuropathic facial pain syndrome. The procedure was tolerated well, and the trial stimulator provided promising results. The permanent MCS generator needed to be reprogrammed at the time of the 5-week follow-up visit to optimize symptom relief. The patient demonstrated dramatic improvements in her neuropathic facial and oral pain, including improvements in swallowing toleration, after the 5-week follow-up examination with subthreshold MCS. A decline in treatment efficacy also occurred 2 years after implantation due to generator depletion. Symptom improvement returned with stimulation after the generator was replaced. CONCLUSION A novel implantable MCS system was used to treat this patient's neuropathic facial pain. Durable improvements were noted not only in her facial pain, but also in swallowing toleration. The ultimate role of MCS in the treatment of pain conditions is still not well-defined but might play a part in refractory cases and, as in this case, might improve other functional issues, including dysphagia.

Motor Cortex Stimulation for Intractable Facial Pain

2012 ◽  
pp. 1487-1492
Author(s):  
Sameer A. Sheth ◽  
Matthew K. Mian ◽  
Bradley R. Buchbinder ◽  
Emad N. Eskandar
Keyword(s):  
Motor Cortex ◽  
Facial Pain ◽  
Motor Cortex Stimulation

Motor cortex stimulation in deafferentation facial pain

2018 ◽  
Vol 82 (4) ◽  
pp. 70 ◽  
Author(s):  
G. I. Moysak ◽  
D. A. Rzaev ◽  
V. M. Dzhafarov ◽  
K. V. Slavin
Keyword(s):  
Motor Cortex ◽  
Facial Pain ◽  
Motor Cortex Stimulation

Motor cortex stimulation for neuropathic facial pain

2003 ◽  
Vol 25 (2) ◽  
pp. 157-161 ◽  
Author(s):  
Nikolai G. Rainov ◽  
Volkmar Heidecke
Keyword(s):  
Motor Cortex ◽  
Facial Pain ◽  
Motor Cortex Stimulation

scholarly journals What Are the Results and the Prognostic Factors of Motor Cortex Stimulation in Patients with Facial Pain? A Systematic Review of the Literature

2021 ◽  
pp. 1-6
Author(s):  
Alessandro Rapisarda ◽  
Eleonora Ioannoni ◽  
Alessandro Izzo ◽  
Nicola Montano
Keyword(s):  
Motor Cortex ◽  
Facial Pain ◽  
Univariate Analysis ◽  
Implantation Rate ◽  
Long Term Results ◽  
Motor Cortex Stimulation ◽  
Younger Age

<b><i>Introduction:</i></b> Facial pain (FP) is a type of neuropathic pain which recognizes both central and peripheral causes. It can be difficult to treat because it can often become resistant to pharmacological treatments. Motor Cortex Stimulation (MCS) has been used in selected cases, but the correct indications of MCS in FP have not been fully established. Here we systematically reviewed the literature regarding MCS in FP analysing the results of this technique and studying the possible role of different factors in the prognosis of these patients. <b><i>Methods:</i></b> A literature search was performed through different databases (PubMed, Scopus, and Embase) according to PRISMA guidelines using the following terms in any possible combination: “facial pain” or “trigeminal” or “anaesthesia dolorosa” and “motor cortex stimulation.” <b><i>Results:</i></b> 111 articles were reviewed, and 12 studies were included in the present analysis for a total of 108 patients. Overall, at latest follow-up (FU), 70.83% of patients responded to MCS. The preoperative VAS significantly decreased at the latest FU (8.83 ± 1.17 and 4.31 ± 2.05, respectively; <i>p</i> &#x3c; 0.0001). Younger age (<i>p</i> = 0.0478) and a peripheral FP syndrome (<i>p</i> = 0.0006) positively affected the definitive implantation rate on univariate analysis. Younger age emerged as a factor strongly associated to a higher probability to go to a definitive MCS implant on multivariate analysis (<i>p</i> = 0.0415). <b><i>Conclusion:</i></b> Our results evidenced the effectiveness of MCS in treating FP. Moreover, the younger age emerged as a positive prognostic factor for definitive implantation. Further studies with longer FU are needed to better evaluate the long-term results of MCS.

Motor cortex stimulation and neuropathic facial pain

2006 ◽  
Vol 21 (6) ◽  
pp. 1-4 ◽  
Author(s):  
Jaimie M. Henderson ◽  
Shivanand P. Lad
Keyword(s):  
Neuropathic Pain ◽  
Motor Cortex ◽  
Facial Pain ◽  
Facial Trauma ◽  
Trigeminal System ◽  
Motor Cortex Stimulation ◽  
Dental Surgery ◽  
Trigeminal Neuropathic Pain ◽  
Pathological Conditions ◽  
Device Programming

✓Trigeminal neuropathic pain is a syndrome of severe, constant facial pain related to disease of or injury to the trigeminal nerve or ganglion. Causes of this type of pain can include injury from sinus or dental surgery, skull and/or facial trauma, or intentional destruction for therapeutic reasons (deafferentation) as well as intrinsic pathological conditions in any part of the trigeminal system. Motor cortex stimulation (MCS) is a relatively new technique that has shown some promise in the treatment of trigeminal neuropathic pain. This technique has the potential to revolutionize the treatment of chronic pain. The authors present a review of the literature, focusing on surgical technique, device programming, safety, and efficacy, and suggest some initial guidelines for standardization of these aspects. It is important to evaluate MCS critically in a prospective, controlled fashion.

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