Motor cortex stimulation for trigeminal neuropathic or deafferentation pain

An institutional case series experience

Ahmed Raslan, Morad Nasseri, Diaa Bahgat, Emun Abdu, Kim Burchiel

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Background: Trigeminal neuropathy is a rare, devastating condition that can be intractable and resistant to treatment. When medical treatment fails, invasive options are limited. Motor cortex stimulation (MCS) is a relatively recent technique introduced to treat central neuropathic pain. The use of MCS to treat trigeminal neuropathic or deafferentation pain is not widespread and clinical data in the medical literature that demonstrate efficacy are limited. Method: We retrospectively reviewed patients with trigeminal neuropathic or trigeminal deafferentation pain who were treated at the Oregon Health & Science University between 2001 and 2008 by 1 neurosurgeon using MCS. Results: Eight of 11 patients (3 male, 8 female) underwent successful permanent implantation of an MCS system. All 8 patients reported initial satisfactory pain control. Three failed to experience continued pain control (6 months of follow-up). Five continued to experience long-term pain control (mean follow-up, 33 months). Average programming sessions were 2.2/year (all 8 patients) and 1.55/year (5 patients who sustained long-term pain control). Patients with anesthesia dolorosa or trigeminal deafferentation pain who had previously undergone ablative trigeminal procedures responded poorly to MCS. We encountered no perioperative complications. Conclusion: MCS is a safe and potentially effective therapy in certain patients with trigeminal neuropathy.

Original languageEnglish (US)
Pages (from-to)83-88
Number of pages6
JournalStereotactic and Functional Neurosurgery
Volume89
Issue number2
DOIs
StatePublished - Apr 2011

Fingerprint

Motor Cortex
Neuralgia
Trigeminal Nerve Diseases
Pain
Therapeutics
Anesthesia
Health

Keywords

  • Motor cortex stimulation
  • Trigeminal deafferentation pain
  • Trigeminal neuropathic pain
  • Trigeminal neuropathy

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Motor cortex stimulation for trigeminal neuropathic or deafferentation pain : An institutional case series experience. / Raslan, Ahmed; Nasseri, Morad; Bahgat, Diaa; Abdu, Emun; Burchiel, Kim.

In: Stereotactic and Functional Neurosurgery, Vol. 89, No. 2, 04.2011, p. 83-88.

Research output: Contribution to journalArticle

@article{0fd1a0514a164171ad52e5943f3f0c14,
title = "Motor cortex stimulation for trigeminal neuropathic or deafferentation pain: An institutional case series experience",
abstract = "Background: Trigeminal neuropathy is a rare, devastating condition that can be intractable and resistant to treatment. When medical treatment fails, invasive options are limited. Motor cortex stimulation (MCS) is a relatively recent technique introduced to treat central neuropathic pain. The use of MCS to treat trigeminal neuropathic or deafferentation pain is not widespread and clinical data in the medical literature that demonstrate efficacy are limited. Method: We retrospectively reviewed patients with trigeminal neuropathic or trigeminal deafferentation pain who were treated at the Oregon Health & Science University between 2001 and 2008 by 1 neurosurgeon using MCS. Results: Eight of 11 patients (3 male, 8 female) underwent successful permanent implantation of an MCS system. All 8 patients reported initial satisfactory pain control. Three failed to experience continued pain control (6 months of follow-up). Five continued to experience long-term pain control (mean follow-up, 33 months). Average programming sessions were 2.2/year (all 8 patients) and 1.55/year (5 patients who sustained long-term pain control). Patients with anesthesia dolorosa or trigeminal deafferentation pain who had previously undergone ablative trigeminal procedures responded poorly to MCS. We encountered no perioperative complications. Conclusion: MCS is a safe and potentially effective therapy in certain patients with trigeminal neuropathy.",
keywords = "Motor cortex stimulation, Trigeminal deafferentation pain, Trigeminal neuropathic pain, Trigeminal neuropathy",
author = "Ahmed Raslan and Morad Nasseri and Diaa Bahgat and Emun Abdu and Kim Burchiel",
year = "2011",
month = "4",
doi = "10.1159/000323338",
language = "English (US)",
volume = "89",
pages = "83--88",
journal = "Stereotactic and Functional Neurosurgery",
issn = "1011-6125",
publisher = "S. Karger AG",
number = "2",

}

TY - JOUR

T1 - Motor cortex stimulation for trigeminal neuropathic or deafferentation pain

T2 - An institutional case series experience

AU - Raslan, Ahmed

AU - Nasseri, Morad

AU - Bahgat, Diaa

AU - Abdu, Emun

AU - Burchiel, Kim

PY - 2011/4

Y1 - 2011/4

N2 - Background: Trigeminal neuropathy is a rare, devastating condition that can be intractable and resistant to treatment. When medical treatment fails, invasive options are limited. Motor cortex stimulation (MCS) is a relatively recent technique introduced to treat central neuropathic pain. The use of MCS to treat trigeminal neuropathic or deafferentation pain is not widespread and clinical data in the medical literature that demonstrate efficacy are limited. Method: We retrospectively reviewed patients with trigeminal neuropathic or trigeminal deafferentation pain who were treated at the Oregon Health & Science University between 2001 and 2008 by 1 neurosurgeon using MCS. Results: Eight of 11 patients (3 male, 8 female) underwent successful permanent implantation of an MCS system. All 8 patients reported initial satisfactory pain control. Three failed to experience continued pain control (6 months of follow-up). Five continued to experience long-term pain control (mean follow-up, 33 months). Average programming sessions were 2.2/year (all 8 patients) and 1.55/year (5 patients who sustained long-term pain control). Patients with anesthesia dolorosa or trigeminal deafferentation pain who had previously undergone ablative trigeminal procedures responded poorly to MCS. We encountered no perioperative complications. Conclusion: MCS is a safe and potentially effective therapy in certain patients with trigeminal neuropathy.

AB - Background: Trigeminal neuropathy is a rare, devastating condition that can be intractable and resistant to treatment. When medical treatment fails, invasive options are limited. Motor cortex stimulation (MCS) is a relatively recent technique introduced to treat central neuropathic pain. The use of MCS to treat trigeminal neuropathic or deafferentation pain is not widespread and clinical data in the medical literature that demonstrate efficacy are limited. Method: We retrospectively reviewed patients with trigeminal neuropathic or trigeminal deafferentation pain who were treated at the Oregon Health & Science University between 2001 and 2008 by 1 neurosurgeon using MCS. Results: Eight of 11 patients (3 male, 8 female) underwent successful permanent implantation of an MCS system. All 8 patients reported initial satisfactory pain control. Three failed to experience continued pain control (6 months of follow-up). Five continued to experience long-term pain control (mean follow-up, 33 months). Average programming sessions were 2.2/year (all 8 patients) and 1.55/year (5 patients who sustained long-term pain control). Patients with anesthesia dolorosa or trigeminal deafferentation pain who had previously undergone ablative trigeminal procedures responded poorly to MCS. We encountered no perioperative complications. Conclusion: MCS is a safe and potentially effective therapy in certain patients with trigeminal neuropathy.

KW - Motor cortex stimulation

KW - Trigeminal deafferentation pain

KW - Trigeminal neuropathic pain

KW - Trigeminal neuropathy

UR - http://www.scopus.com/inward/record.url?scp=79551555778&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79551555778&partnerID=8YFLogxK

U2 - 10.1159/000323338

DO - 10.1159/000323338

M3 - Article

VL - 89

SP - 83

EP - 88

JO - Stereotactic and Functional Neurosurgery

JF - Stereotactic and Functional Neurosurgery

SN - 1011-6125

IS - 2

ER -