title: Long-term motor cortex stimulation for phantom limb pain.
abstract: We present the long-term course of motor cortex stimulation to relieve a case of severe burning phantom arm pain after brachial plexus injury and amputation. During 16-year follow-up the device continued to provide efficacious analgesia. However, several adjustments of stimulation parameters were required, as were multiple pulse generator changes, antibiotics for infection and one electrode revision due to lead migration. Steady increases in stimulation parameters over time were required. One of the longest follow-ups of motor cortex stimulation is described; the case illustrates challenges and pitfalls in neuromodulation for chronic pain, demonstrating strategies for maintaining analgesia and overcoming tolerance.
authors.affiliation: Nuffield Department of Surgical Sciences and Department of Neurological Surgery, Oxford Functional Neurosurgery, Oxford University Hospitals , Oxford , UK.
authors.forename: Erlick A C
authors.initials: EA
authors.lastname: Pereira
authors.forename: Tom
authors.initials: T
authors.lastname: Moore
authors.forename: Liz
authors.initials: L
authors.lastname: Moir
authors.forename: Tipu Z
authors.initials: TZ
authors.lastname: Aziz
mesh_terms: D000328:Adult; D001917:Brachial Plexus / Q000601:surgery*; D005260:Female; D006801:Humans; D009044:Motor Cortex / Q000601:surgery*; D010147:Pain Measurement / Q000379:methods; D010591:Phantom Limb / Q000175:diagnosis / Q000628:therapy*; D013995:Time; D016896:Treatment Outcome
keywords: long-term outcome; motor cortex stimulation; neuromodulation; phantom limb pain