Deep brain stimulation for chronic pain

Louis A. Whitworth, Julius Fernández, Claudio A. Feler

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

The control of chronic intractable pain has been a challenge to neurosurgeons for decades. Over the last 30 years there has been a shift in treatment paradigms from ablation to neuroaugmentation therapies. Surgical ablative treatments have in common the risk of motor system deficits and delayed deafferentation pain. In recent years, electrical stimulation and intrathecal drug delivery have become the favored interventional treatments for chronic benign pain syndromes. The use of electrical stimulation on the human brain to modulate pain dates back to the 1950s. Paramount to obtaining a good outcome with deep brain stimulation (DBS) is the proper selection of a patient and a correct target. In contemporary times, selection of patients for DBS procedures should be limited to those who experience neuropathic pain syndromes and more specifically complain of constant, steady burning or aching pain. These patients must first be considered for stimulation at other sites, such as spinal cord, nerve root, or peripheral nerve. Patients who have had trials with one of these other targets may have failed to respond for a variety of reasons. If the failure has been due to an inability to produce an overlap of paresthesia on the pain segment, the patient may be considered a candidate for DBS. Other reasons for failure of the previously attempted targets are likely to predict failure of DBS as well.

Original languageEnglish (US)
Pages (from-to)183-193
Number of pages11
JournalSeminars in Neurosurgery
Volume15
Issue number2-3
StatePublished - Jun 2004

Fingerprint

Deep Brain Stimulation
Chronic Pain
Patient Selection
Electric Stimulation
Pain
Intractable Pain
Paresthesia
Spinal Nerve Roots
Neuralgia
Therapeutics
Back Pain
Peripheral Nerves
Spinal Cord
Brain
Pharmaceutical Preparations

Keywords

  • Pain
  • Stimulation
  • Thalamus

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Whitworth, L. A., Fernández, J., & Feler, C. A. (2004). Deep brain stimulation for chronic pain. Seminars in Neurosurgery, 15(2-3), 183-193.

Deep brain stimulation for chronic pain. / Whitworth, Louis A.; Fernández, Julius; Feler, Claudio A.

In: Seminars in Neurosurgery, Vol. 15, No. 2-3, 06.2004, p. 183-193.

Research output: Contribution to journalArticle

Whitworth, LA, Fernández, J & Feler, CA 2004, 'Deep brain stimulation for chronic pain', Seminars in Neurosurgery, vol. 15, no. 2-3, pp. 183-193.
Whitworth LA, Fernández J, Feler CA. Deep brain stimulation for chronic pain. Seminars in Neurosurgery. 2004 Jun;15(2-3):183-193.
Whitworth, Louis A. ; Fernández, Julius ; Feler, Claudio A. / Deep brain stimulation for chronic pain. In: Seminars in Neurosurgery. 2004 ; Vol. 15, No. 2-3. pp. 183-193.
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