Behandeling van centrale pijn en aangezichtspijn

Two patients with chronic refractory central pain and neuropathic facial neuralgia were treated with electronic stimulation of the motor cortex. The first patient, a 55-year-old male, developed pain in the left arm one year after ischemic damage of the right internal capsule. The other patient, a 40-year-old woman, had severe facial neuralgia after removal of an adenoma from the submandibular salivary gland. In both patients the pain decreased markedly following motor cortex stimulation (MCS). In total 10 patients with refractory neuropathic pain were treated with MCS. They were selected after neurological, clinical neurophysiological and psychological evaluation. In 1 patient the test electrode was removed because of infection. After 1 year there still was significant pain reduction in 4 of the 9 patients. This also applied to 2 of the 5 patients who could be followed up for 2 years. Further investigation into this treatment seems justified.