Mesothalamic discharge in a chronic pain, allergy and fluid retention syndrome (case report).
A 32-year-old woman was bedridden for a year because of chronic pain and headaches. She had insomnia, depression, suicidal thoughts and a severe chemical allergy. She had been on steroid therapy for two years and became Cushingoid with striae in the arm pits, groins and abdomen. However, she had no hypertension, nor the buffalo fat and hirsutism. She was very edematous, with a weight gain from 112 to 180 lbs. The fluid retention did not conform to the syndrome of inappropriate antidiuretic hormone. Studies revealed abnormal scalp EEG discharges and high-voltage seizure discharges in the posterior thalamus. Electrothalamic stimulation suppressed the thalamic discharges and relieved the patient's pelvic pain and headaches. After one month of several thalamic stimulations per day, she was able to get out of bed and ambulate. In addition, the patient no longer was edematous and was tolerating perfumes and floor detergents. Steroids were progressively reduced without complications of withdrawal. She went from a completely steroid dependent state to independent during the first 1-1/2 yrs of thalamic stimulation. With continued thalamic stimulation she has done well for 8-1/2 yrs, weighs 112 lbs, keeps house and drives a car. It's speculated the illness is a chronic pain multiple syndrome predominantly due to mesothalamic discharges and body infirmities. The mesothalamic discharge implicated neural networks, which represent biologic systems, i.e. pain, sleep, fluid retention, etc. Therapeutic stimulation attenuates the discharges and the neural networks return to their normal set points of homeostasis.
Andy
O J
OJ
Dept. of Neurosurgery, U. of Mississippi Medical Center, Jackson 39216, USA.
Nicholas
W
W
Dearman
C
C
D000324:Adrenocorticotropic Hormone; D000328:Adult; D002908:Chronic Disease; D003348:Cortisone / Q000097:blood; D004487:Edema / Q000503:physiopathology*; D004558:Electric Stimulation; D004567:Electrodes, Implanted; D004569:Electroencephalography; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000503:physiopathology*; D010146:Pain / Q000503:physiopathology*; D013788:Thalamus / Q000503:physiopathology*
D000324:Adrenocorticotropic Hormone; D003348:Cortisone