Stereotaxic ventroposteromedial thalamotomy in the treatment. Clinical observations and physiopathological considerations
Bidziński, J.; Krzymiński, T.; Ostrowski, K.
Neurologia i Neurochirurgia Polska 13(4): 417-422
1979
ISSN/ISBN: 0028-3843 PMID: 384284 Document Number: 139192
In 6 patients the authors performed stereotaxic ventroposteromedial thalamotomy for abolition or reduction of pain. The operation produced lesions in the centrum medianum and parasfascicular nucleus. In 2 cases unilateral operation was performed contralaterally to the side of pain, in the remaining cases the operation was done bilaterally as a one-step procedure. Postoperative follow demonstrated that in 1 case improvement was completely absent, in 4 initial good effect was transient and pain returned after several weeks and in only 1 patient very good effect persists for over 12 months. In the light of these experiences and a survey of the pertinent literature the authors reach the conclusion that limited stereotatic lesion of the so called non-specific pain-transmitting thalamic nuclei produces permanent abolition or alleviation of pain in few cases only. The pathophysiology of pain is discussed in the light of these data.