Introduction: Although motor cortex stimulation (MCS) has been used for more than 20 years in the treatment of chronic neuropathic pain, there is still a debate in the efficacy of MCS.
Methods: To investigate the long-term results and the factors associated with long-term success in chronic MCS, 21 patients who underwent MCS trial were classified into central poststroke pain (CPSP), central pain of spinal cord injury (SCI pain), and peripheral neuropathic pain (PNeP), and we investigated the clinical factors associated with long-term success and degree of pain relief.
Results: Of the 21 patients, 16 (76.2%) had a successful trial and underwent chronic MCS. In the long-term follow-up (53 ± 39 months), only type of pain (CPSP and PNeP) was associated with long-term success defined as more than 30% pain relief compared with baseline (p<0.05, chi-square test). The difference in pain relief was not significant in SCI pain (>0.05, one-way Annova). The other variables did not show any significant influence in the long-term success and degree of pain relief (>0.05, one-way Annova).
Conclusions: MCS was more effective in the treatment of chronic neuropathic pain of CPSP and PNeP than that of SCI pain in the long-term.
Patient Care: this would be of help to select in which kind of neuropathic pain would be helpful by MCS.
Learning Objectives: To learn about the long-term results of motor cortex stimulation in neuropathic pain syndrome
References: 9. Son BC, Kim MC, Moon DE, Kang JK: Motor cortex stimulation in a patient with intractable complex regional pain syndrome type II with hemibody involvement. Case report. J Neurosurg 2003;98:175-179.
17. Son B, Choi ES, JT Hong, SW Lee. Motor cortex stimulation for central pain caused by traumatic brain injury. Pain 2006;121:43-52.
Long-term Results of Motor Cortex Stimulation in the Treatment of Chronic, Intractable Neuropathic Pain. Im SH, Ha SW, Kim DR, Son BC. Stereotact Fucnt Neurosurg 2015:93:212-218