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Minim Invasive Neurosurg 2004; 47(5): 273-277
DOI: 10.1055/s-2004-830092
Original Article
© Georg Thieme Verlag Stuttgart · New York

Image-Guided Motor Cortex Stimulation in Patients with Central Pain

W.  Tirakotai1 , T.  Riegel1 , U.  Sure1 , J.  Rohlfs1 , A.  Gharabaghi2 , H.  Bertalanffy1 , D.  Hellwig1
  • 1Department of Neurosurgery, Philipps University, Marburg, Germany
  • 2Department of Neurosurgery, Eberhard-Karls University, Tübingen, Germany
Further Information

Publication History

Publication Date:
02 December 2004 (online)

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Abstract

According to recent clinical data, motor cortex stimulation (MCS) is an alternative treatment for central pain syndromes. We present our minimally invasive technique of image guidance for the placement of the motor cortex-stimulating electrode and assess the clinical usefulness of both neuronavigation and vacuum headrest. Five patients suffering from central pain underwent MCS with the guidance of a frameless stereotactic system (BrainLab AG, Munich, Germany). The neuronavigation was used for identification of the precentral gyrus and accurate planning of the single burr hole. The exact location was reconfirmed by an intraoperative stimulation test. Postoperative clinical and neuroradiological evaluations were performed in each patient. The navigation system worked properly in all 5 neurosurgical cases. Determination of the placement of stimulating electrode was possible in every case. All patients obtained postoperative pain relief. No surgical complication occurred, and the postoperative course was uneventful in all patients. This preliminary experience may confirm image guidance as a useful tool for the surgery of MCS. Additionally, minimal and safe exposure can be achieved using a single burr hole and vacuum headrest.

Key words

Central pain - intraoperative somatosensory - motor cortex stimulation - neuronavigation - thalamic pain

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Wuttipong TirakotaiM. D., M. Sc. 

Neurochirurgische Klinik der Philipps Universität Marburg

Baldingerstraße

35033 Marburg

Germany

Phone: +49-6421-286-6447

Fax: +49-6421-286-6415 ·

Email: hellwigd@med.uni-marburg.de