Deep Brain Stimulation for Dejerine-Roussy Syndrome: Case Report

Abstract

Background:

The term “central post-stroke pain” is more appropriate to describe neuropathic pain following a cerebrovascular accident. Most patients complain of burning and other symptoms like lacerating and shooting pain. Treatment options for central pain are limited in number and efficacy.

Case Report:

This paper reports on a 47-year-old man with central post-stroke pain refractory to treatment. The patient underwent insertion of a deep brain stimulator utilizing the Leksell frame. The target was the left centromedian thalamic nuclei. He had a qualitative symptomatic improvement.

Conclusion:

Deep brain stimulation can be a useful tool when all other modalities have failed. It is a minimally invasive neurosurgical procedure that may improve the quality of life in carefully selected (often desperate) patients with central post-stroke pain.

Key words

deep brain stimulation - Dejerine-Roussy syndrome - central post-stroke pain

• References

• 1 Hansson P. Post-stroke pain case study: clinical characteristics, therapeutic options and long-term follow-up. Eur J Neurol 2004; 11 (Suppl. 01) 22-30
• 2 Bassetti CL, Jagella EC. Joseph Jules Dejerine (1849–1917). J Neurol 2006; 253: 823-824
• 3 Schurch B, Dollfus P. The “Dejerines”: an historical review and homage to two pioneers in the field of neurology and their contribution to the understanding of spinal cord pathology. Spinal Cord 1998; 36: 78-86
• 4 Schmahmann JD. Vascular Syndromes of the thalamus. Stroke 2003; 34: 2264-2278
• 5 Nicholson BD. Evaluation and treatment of central pain syndromes. Neurology 2004; 62 (Suppl. 02) 30-36
• 6 Kumar B, Kalita J, Kumar G et al. Central post-stroke pain: A review of pathophysiology and treatment. Anesth Analg 2009; 108: 1645-1657
• 7 Andersen G, Vestergaard K, Ingeman-Nielsen M et al. Incidence of central post-stroke pain. Pain 1995; 61: 187-193
• 8 Widar M, Ahlstrom G. Disability after a stroke and the influence of long-term pain on everyday life. Scand J Caring Sci 2002; 16: 302-310
• 9 Pickering AE, Thornton SR, Love-Jones SJ et al. Analgesia in conjunction with normalisation of thermal sensation following deep brain stimulation for central post-stroke pain. Pain 2009; 147: 299-304
• 10 Awan NR, Lozano A, Hamani C. Deep brain stimulation: current and future perspectives. Neurosurg Focus 2009; 27: E2