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Neurol. Med. Chir. (Tokyo) · Jan 2010
Case ReportsMotor cortex stimulation for intractable neuropathic facial pain related to multiple sclerosis.
- Takafumi Tanei, Yasukazu Kajita, and Toshihiko Wakabayashi.
- Department of Neurosurgery, Nagoya Central Hospital, Nakamura-ku, Nagoya, Aichi, Japan. nsgtakasyun@msn.com
- Neurol. Med. Chir. (Tokyo). 2010 Jan 1; 50 (7): 604-7.
AbstractA 33-year-old man presented with ongoing severe right facial pain and sensory disturbances caused by multiple sclerosis (MS). Neuroimaging demonstrated demyelinating lesions in the right dorsal pons and medulla oblongata. The pain was refractory to carbamazepine at 800 mg/day, gabapentin at 1800 mg/day, morphine at 30 mg/day, amitriptyline at 60 mg/day, and diazepam at 4 mg/day, along with twice-monthly ketamine (60 mg) drip infusions. The patient underwent motor cortex stimulation (MCS), resulting in >60% pain relief, reduction in the required doses of pain medications, and discontinuation of ketamine administration. MCS is effective for MS-related neuropathic facial pain.
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