TY - JOUR
T1 - Case series
T2 - Deep brain stimulation for facial pain
AU - Kashanian, Alon
AU - DiCesare, Jasmine A.T.
AU - Rohatgi, Pratik
AU - Albano, Luigi
AU - Krahl, Scott E.
AU - Bari, Ausaf
AU - de Salles, Antonio
AU - Pouratian, Nader
N1 - Publisher Copyright:
Copyright © 2020 by the Congress of Neurological Surgeons
PY - 2020/11/1
Y1 - 2020/11/1
N2 - BACKGROUND: Deep brain stimulation (DBS) has been used for chronic pain for decades, but its use is limited due to a lack of reliable data about its efficacy for specific indications. OBJECTIVE: To report on 9 patients who underwent DBS for facial pain, with a focus on differences in outcomes between distinct etiologies. METHODS: We retrospectively reviewed 9 patients with facial pain who were treated with DBS of the ventral posteromedial nucleus of the thalamus and periventricular gray. We report on characteristics including facial pain etiology, complications, changes in pain scores using the visual analog scale (VAS), and willingness to undergo DBS again. RESULTS: Nine patients underwent DBS for either poststroke, post-traumatic, postherpetic, or atypical facial pain. Eight patients (89%) were permanently implanted. Seven patients had sufficient follow-up (mean 40.3 mo). Of these 7 patients, average VAS scores decreased from 9.4 to 6.1 after DBS. The average decrease in VAS was 55% for post-traumatic facial pain (2 patients), 45% for poststroke (2 patients), 15% for postherpetic neuralgia (2 patients), and 0% for atypical facial pain (1 patient). Three of the 8 implanted patients (38%) had complications which required removal of hardware. Only 2 of 7 (29%) patients met classical criteria for responders (50% decrease in pain scores). However, among 4 patients who were asked about willingness to undergo DBS again, all expressed that they would repeat the procedure. CONCLUSION: There is a trend towards improvement in pain scores following DBS for facial pain, most prominently with post-traumatic pain.
AB - BACKGROUND: Deep brain stimulation (DBS) has been used for chronic pain for decades, but its use is limited due to a lack of reliable data about its efficacy for specific indications. OBJECTIVE: To report on 9 patients who underwent DBS for facial pain, with a focus on differences in outcomes between distinct etiologies. METHODS: We retrospectively reviewed 9 patients with facial pain who were treated with DBS of the ventral posteromedial nucleus of the thalamus and periventricular gray. We report on characteristics including facial pain etiology, complications, changes in pain scores using the visual analog scale (VAS), and willingness to undergo DBS again. RESULTS: Nine patients underwent DBS for either poststroke, post-traumatic, postherpetic, or atypical facial pain. Eight patients (89%) were permanently implanted. Seven patients had sufficient follow-up (mean 40.3 mo). Of these 7 patients, average VAS scores decreased from 9.4 to 6.1 after DBS. The average decrease in VAS was 55% for post-traumatic facial pain (2 patients), 45% for poststroke (2 patients), 15% for postherpetic neuralgia (2 patients), and 0% for atypical facial pain (1 patient). Three of the 8 implanted patients (38%) had complications which required removal of hardware. Only 2 of 7 (29%) patients met classical criteria for responders (50% decrease in pain scores). However, among 4 patients who were asked about willingness to undergo DBS again, all expressed that they would repeat the procedure. CONCLUSION: There is a trend towards improvement in pain scores following DBS for facial pain, most prominently with post-traumatic pain.
KW - Chronic pain
KW - Deep brain stimulation
KW - Facial pain
KW - Neuromodulation
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U2 - 10.1093/ons/opaa170
DO - 10.1093/ons/opaa170
M3 - Article
C2 - 32542398
AN - SCOPUS:85093538405
SN - 2332-4252
VL - 19
SP - 510
EP - 517
JO - Operative Neurosurgery
JF - Operative Neurosurgery
IS - 5
ER -