[Contribution of thalamotomy, cordotomy and dorsal root entry zone Caudalis trigeminalis lesions in the treatment of chronic pain].
Ablative neurosurgical methods are mainly proposed in cases of nociceptive pain, but, at present, medical treatments and local pharmacotherapy (intrathecal and intracerebroventricular) are often very effective in this context. Moreover, neuropathic pain is well controlled by äugmentative techniques, except painful paroxysms. If a destructrive method is necessary, it is selective, performed according to precise neurophysiological and anatomical data with the frequent use of percutaneous and/or stereotactic techniques: the lesion of caudalis DREZ in treatment of neuropathic trigeminal pain, the antero-lateral cordotomy in the treatment of unilateral severe cancer pain and several kinds of thalamotomy.
Broggi
G
G
Département de Neurochirurgie, Istituto Nazionale Neurologico C. Besta, Via Celoria 11, I-20133 Milan, Italie. gbroggi@compuserve.com
Dones
I
I
Ferroli
P
P
Franzini
A
A
Pluderi
M
M
D002908:Chronic Disease; D002818:Cordotomy / Q000379:methods; D006801:Humans; D010146:Pain / Q000209:etiology / Q000601:surgery*; D013788:Thalamus / Q000601:surgery*; D014275:Trigeminal Caudal Nucleus