Treatment of Chronic Pain by Deep Brain Stimulation: Long Term Follow-up and Review of the Literature

摘要: Since the senior author's (J.E.A.) first report in 1972 of use deep brain stimulation (DBS) to control chronic pain, electrodes for DBS have been implanted 141 patients. Of reported series, this one has largest number patients and longest period follow-up. The mean age study was 51.2 years. length follow-up 80 months. Patients had experienced pain a 65 months before attempted; all exhausted other medical surgical therapies. For purposes study, states were characterized as being either nociceptive or deafferentation nature. Nociceptive treated primarily by periaqueductal periventricular gray, sensory thalamus. Eighty-four which included thalamic syndrome (25 cases), peripheral neuropathic (16 anesthesia dolorosa (12 paraplegia (11 postcordotomy dyesthesia (5 phantom limb thoracic neuralgia (4 miscellaneous (6 cases). We 57 with states, 51 low back skeletal 6 from invasion cancer. Initial relief obtained 83 (59%). After months, 42 (31%) continued obtain significant DBS. Some particularly did not seem respond Major complications therapy wound infection (12%) intracranial hemorrhage (3.5%); there death series (0.7%).(ABSTRACT TRUNCATED AT 250 WORDS)