[Spinal cord stimulation for thalamic pain: Case report and review of the current literature].
BACKGROUND
Spinal cord stimulation (SCS) is an established procedure for treatment of chronic neuropathic pain of peripheral origin. The efficacy of SCS in case of central poststroke pain (CPSP), especially thalamic pain, has not been adequately proven.


OBJECTIVE
The efficacy of SCS as an extracranial neurostimulation method for the management of central pain syndrome was investigated.


METHODS
In this study, relevant pharmacological and nonpharmacological measures for central pain management were reviewed. A case of successful SCS for thalamic pain after ischemic insult is presented. Explanatory approaches of pathophysiological processes and a review of the current literature underline our results.


RESULTS
In the case presented, SCS was found effective in the treatment of thalamic pain.


CONCLUSIONS
The efficacy of SCS might be caused by segmental and supraspinal processes and collaboration of activating and inhibiting pathways. The integrity of the spinothalamic tract is mandatory. SCS is a treatment option for central pain syndrome, especially thalamic pain. Comparable studies confirm the potency of this technique. In contrast to other neuromodulation procedures spinal cord stimulation is less invasive, has a lower perioperative risk and is often less expensive. Further studies are needed to define its potential and role in the treatment of thalamic pain.
Klinik für Neurochirurgie, Universitätsklinikum Jena, Erlanger Allee 101, 07747, Jena, Deutschland. denise.feierabend@med.uni-jena.de.
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Feierabend
Klinik für Neurochirurgie, Universitätsklinikum Jena, Erlanger Allee 101, 07747, Jena, Deutschland.
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Frank
Klinik für Neurochirurgie, Universitätsklinikum Jena, Erlanger Allee 101, 07747, Jena, Deutschland.
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Kalff
Klinik für Neurochirurgie, Universitätsklinikum Jena, Erlanger Allee 101, 07747, Jena, Deutschland.
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Reichart
D002545:Brain Ischemia / Q000150:complications / Q000503:physiopathology / Q000628:therapy; D003131:Combined Modality Therapy; D006801:Humans; D010146:Pain / Q000503:physiopathology*; D059408:Pain Management / Q000379:methods*; D062187:Spinal Cord Stimulation / Q000379:methods*; D013133:Spinothalamic Tracts / Q000503:physiopathology; D013786:Thalamic Diseases / Q000503:physiopathology* / Q000628:therapy*
Central poststroke pain; Ischemia; Neuropathic pain; Neurostimulation; Spinal cord stimulation, epidural