Pain Relief and Functional Recovery in Patients with Complex Regional Pain Syndrome after Motor Cortex Stimulation

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dc.contributor Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP FONOFF, Erich Talamoni FMUSP-HC
HAMANI, Clement
ANDRADE, Daniel Ciampi de FMUSP-HC
TEIXEIRA, Manoel Jacobsen FMUSP-HC 2011
dc.identifier.citation STEREOTACTIC AND FUNCTIONAL NEUROSURGERY, v.89, n.3, p.167-172, 2011
dc.identifier.issn 1011-6125
dc.description.abstract In addition to pain and neurovegetative symptoms, patients with severe forms of complex regional pain syndrome (CRPS) develop a broad range of symptoms, including sensory disturbances, motor impairment and dystonic posturing. While most patients respond to medical therapy, some are considered refractory and become surgical candidates. To date, the most commonly used surgical procedure for CRPS has been spinal cord stimulation. This therapy often leads to important analgesic effects, but no sensory or motor improvements. We report on 2 patients with pain related to CRPS and severe functional deficits treated with motor cortex stimulation (MCS) who not only had significant analgesic effects, but also improvements in sensory and motor symptoms. In the long term (27 and 36 months after surgery), visual analog scale pain scores were improved by 60-70% as compared to baseline. There was also a significant increase in the range of motion in the joints of the affected limbs and an improvement in allodynia, hyperpathia and hypoesthesia. Positron emission tomography scan in both subjects revealed that MCS influenced regions involved in the circuitry of pain.
dc.language.iso eng
dc.publisher KARGER
dc.relation.ispartof Stereotactic and Functional Neurosurgery
dc.rights restrictedAccess
dc.subject Complex regional pain syndrome; Motor cortex stimulation; Positron emission tomography; Spinal cord stimulation
dc.subject.other transcranial magnetic stimulation; anterior cingulate cortex; neuropathic pain; electrical-stimulation; focal dystonia; opioid system; circuitry; brain; model
dc.title Pain Relief and Functional Recovery in Patients with Complex Regional Pain Syndrome after Motor Cortex Stimulation
dc.type article
dc.rights.holder Copyright KARGER LIM/26
dc.identifier.doi 10.1159/000324895
dc.identifier.pmid 21494069
dc.type.category original article
dc.type.version publishedVersion FONOFF, Erich Talamoni:HC:IPQ ANDRADE, Daniel Ciampi de:HC:ICESP YENG, Lin Tchia:HC:IOT MARCOLIN, Marco Antonio:HC:IPQ TEIXEIRA, Manoel Jacobsen:FM:MNE · HAMANI, Clement:Univ Toronto, Toronto Western Hosp, Div Neurosurg, Toronto, ON M5T 2S8, Canada 2-s2.0-79953848721 WOS:000290307000006 BASEL SWITZERLAND
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dc.description.index MEDLINE
hcfmusp.citation.scopus 18
hcfmusp.citation.wos 13 Brasil Canadá

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