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.

scholarly journals Optogenetic stimulation of the motor cortex alleviates neuropathic pain in rats of infraorbital nerve injury with/without CGRP knock-down

2020 ◽  
Author(s):  
Jaisan Islam ◽  
Elina KC ◽  
Byeong Ho Oh ◽  
Soochong Kim ◽  
Sang-hwan Hyun ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Motor Cortex ◽  
Trigeminal Neuralgia ◽  
Trigeminal Ganglion ◽  
Primary Motor Cortex ◽  
Infraorbital Nerve ◽  
Motor Cortex Stimulation ◽  
Trigeminal Neuropathic Pain ◽  
Optogenetic Stimulation ◽  
Stimulation Of

Abstract Background Previous studies have reported that electrical stimulation of the motor cortex is effective in reducing trigeminal neuropathic pain; however, the effects of optical motor cortex stimulation remain unclear. Objective The present study aimed to investigate whether optical stimulation of the primary motor cortex can modulate chronic neuropathic pain in rats with infraorbital nerve constriction injury. Methods Animals were randomly divided into a trigeminal neuralgia group, a sham group, and a control group. Trigeminal neuropathic pain was generated via constriction of the infraorbital nerve and animals were treated via selective inhibition of calcitonin gene-related peptide in the trigeminal ganglion. We assessed alterations in behavioral responses in the pre-stimulation, stimulation, and post-stimulation conditions. In vivo extracellular recordings were obtained from the ventral posteromedial nucleus of the thalamus, and viral and α-CGRP expression were investigated in the primary motor cortex and trigeminal ganglion, respectively. Results We found that optogenetic stimulation significantly improved pain behaviors in the trigeminal neuralgia animals and it provided more significant improvement with inhibited α-CGRP state than active α-CGRP state. Electrophysiological recordings revealed decreases in abnormal thalamic firing during the stimulation-on condition. Conclusion Our findings suggest that optical motor cortex stimulation can alleviate pain behaviors in a rat model of trigeminal neuropathic pain. Transmission of trigeminal pain signals can be modulated via knock-down of α-CGRP and optical motor cortex stimulation.

scholarly journals Optogenetic Stimulation of The Motor Cortex Alleviates Neuropathic Pain in Rats of Infraorbital Nerve Injury With/Without CGRP Knock-Down

2020 ◽  
Author(s):  
Jaisan Islam ◽  
Elina KC ◽  
Byeong Ho Oh ◽  
Soochong Kim ◽  
Sang-hwan Hyun ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Motor Cortex ◽  
Trigeminal Neuralgia ◽  
Trigeminal Ganglion ◽  
Primary Motor Cortex ◽  
Infraorbital Nerve ◽  
Motor Cortex Stimulation ◽  
Trigeminal Neuropathic Pain ◽  
Optogenetic Stimulation ◽  
Stimulation Of

Abstract Background: Previous studies have reported that electrical stimulation of the motor cortex is effective in reducing trigeminal neuropathic pain; however, the effects of optical motor cortex stimulation remain unclear. Objective: The present study aimed to investigate whether optical stimulation of the primary motor cortex can modulate chronic neuropathic pain in rats with infraorbital nerve constriction injury.Methods: Animals were randomly divided into a trigeminal neuralgia group, a sham group, and a control group. Trigeminal neuropathic pain was generated via constriction of the infraorbital nerve and animals were treated via selective inhibition of calcitonin gene-related peptide in the trigeminal ganglion. We assessed alterations in behavioral responses in the pre-stimulation, stimulation, and post-stimulation conditions. In vivo extracellular recordings were obtained from the ventral posteromedial nucleus of the thalamus, and viral and α-CGRP expression were investigated in the primary motor cortex and trigeminal ganglion, respectively.Results: We found that optogenetic stimulation significantly improved pain behaviors in the trigeminal neuralgia animals and it provided more significant improvement with inhibited α-CGRP state than active α-CGRP state. Electrophysiological recordings revealed decreases in abnormal thalamic firing during the stimulation-on condition.Conclusion: Our findings suggest that optical motor cortex stimulation can alleviate pain behaviors in a rat model of trigeminal neuropathic pain. Transmission of trigeminal pain signals can be modulated via knock-down of α-CGRP and optical motor cortex stimulation.

Motor Cortex Stimulation in a Three-Year-Old Child With Trigeminal Neuropathic Pain Caused by a Malignant Glioma in the Cerebellopontine Angle: Case Report

Neurosurgery ◽  
2011 ◽  
Vol 69 (2) ◽  
pp. E494-E496 ◽  
Author(s):  
Maxime Delavallee ◽  
Herbert Rooijakkers ◽  
Guus Koerts ◽  
Christian Raftopoulos
Keyword(s):  
Neuropathic Pain ◽  
Motor Cortex ◽  
Evoked Potentials ◽  
Malignant Glioma ◽  
Cerebellopontine Angle ◽  
Motor Evoked Potentials ◽  
Temporal Part ◽  
Motor Cortex Stimulation ◽  
Trigeminal Neuropathic Pain ◽  
Sensory Evoked

Abstract BACKGROUND AND IMPORTANCE: Motor cortex stimulation (MCS) is an accepted treatment in neuropathic pain syndromes. Use of MCS for trigeminal neuropathic pain (TNP) caused by a malignant glioma or in a child has not previously been reported in the literature. CLINICAL PRESENTATION: A 3-year-old boy presented to our department with a right temporal tumor with extension into the cavernous sinus and along the root of the trigeminal nerve up to the protuberance. Six weeks after removal of the temporal part of the tumor, the patient developed medically refractory trigeminal pain associated with tumor progression into the posterior fossa. We decided to remove the tumor from the cerebellopontine angle and residual tumor in the pericavernous area and then gave postoperative radio- and chemotherapy. Five months later, the patient developed unbearable refractory neuropathic pain characterized by a burning sensation in the first and second trigeminal areas. After a multidisciplinary discussion, MCS was recommended. We performed subdural MCS after localization of the central sulcus via anatomic landmarks, neuronavigation, peroperative sensory evoked potentials, and motor evoked potentials. The mother estimated a 75% reduction in the child's pain at 48 hours postoperatively, which continued until the child was pain-free. CONCLUSION: MCS is a minimally invasive surgical technique that seems to be a potential treatment for carefully selected children experiencing very severe and medically refractory neuropathic pain, even in the context of a neoplasm.

scholarly journals Pre-motor versus motor cerebral cortex neuromodulation for chronic neuropathic pain

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Igor Lavrov ◽  
Timur Latypov ◽  
Elvira Mukhametova ◽  
Brian Lundstrom ◽  
Paola Sandroni ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Cerebral Cortex ◽  
Motor Cortex ◽  
Initial Assessment ◽  
Motor Cortex Stimulation ◽  
Chronic Neuropathic Pain ◽  
Long Term Effect ◽  
Stimulation Of

AbstractElectrical stimulation of the cerebral cortex (ESCC) has been used to treat intractable neuropathic pain for nearly two decades, however, no standardized approach for this technique has been developed. In order to optimize targeting and validate the effect of ESCC before placing the permanent grid, we introduced initial assessment with trial stimulation, using a temporary grid of subdural electrodes. In this retrospective study we evaluate the role of electrode location on cerebral cortex in control of neuropathic pain and the role of trial stimulation in target-optimization for ESCC. Location of the temporary grid electrodes and location of permanent electrodes were evaluated in correlation with the long-term efficacy of ESCC. The results of this study demonstrate that the long-term effect of subdural pre-motor cortex stimulation is at least the same or higher compare to effect of subdural motor or combined pre-motor and motor cortex stimulation. These results also demonstrate that the initial trial stimulation helps to optimize permanent electrode positions in relation to the optimal functional target that is critical in cases when brain shift is expected. Proposed methodology and novel results open a new direction for development of neuromodulation techniques to control chronic neuropathic pain.

scholarly journals Neuralgias of the Trigeminal Nerve

2000 ◽  
Vol 5 (1) ◽  
pp. 107-113 ◽  
Author(s):  
Allan S Gordon
Keyword(s):  
Neuropathic Pain ◽  
Differential Diagnosis ◽  
Trigeminal Neuralgia ◽  
Clinical Features ◽  
Trigeminal Nerve ◽  
Postherpetic Neuralgia ◽  
Facial Pain ◽  
The Other ◽  
Atypical Facial Pain ◽  
Trigeminal Neuropathic Pain

Practitioners are often presented with patients who complain bitterly of facial pain. The trigeminal nerve is involved in four conditions that are sometimes mixed up. The four conditions - trigeminal neuralgia, trigeminal neuropathic pain, postherpetic neuralgia and atypical facial pain - are discussed under the headings of clinical features, differential diagnosis, cause and treatment. This article should help practitioners to differentiate one from the other and to manage their care.

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