Risk factors for unpleasant paresthesiae induced by paresthesiae - producing deep brain stimulation
Autor(a) principal: | |
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Data de Publicação: | 1996 |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Arquivos de neuro-psiquiatria (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X1996000100010 |
Resumo: | Paresthesiae-producing deep brain stimulation (stimulation of ventrocaudal nucleus - VC, medial lemniscus - ML or internal capsule - IC) is one of the few procedures to treat the steady element of neural injury pain (NIP) currently available. Reviewing the first 60 patients with NIP submitted to deep brain stimulation (DBS) from 1978 to 1991 at the Division of Neurosurgery, Toronto Hospital, University of Toronto, we observed that 6 patients complained of unpleasant paresthesiae with paresthesiae-producing DBS, preventing permanent electrode implantation in all of them. Such patients accounted for 15% of the failures (6 out of 40 failures) in our series. In an attempt to improve patient selection, we reviewed our patients considering a number of parameters in order to determine risk factors for unpleasant paresthesiae elicited by paresthesiae-producing DBS. The results showed that this response happenned only in patients with brain central pain complaining of evoked pain, secondary to a supratentorial lesion. Age, sex, duration of pain, quality of the steady pain, size of the causative lesion and site (VC,ML,IC) and type (micro or macroelectrode) of surgical exploration were not important factors. Unpleasant paresthesiae in response to dorsal column stimulation, restricted thalamic lesion on computed tomography and the occurrence of associated intermittent pain were considered major risk factors in this subset of patients and the presence of cold allodynia or hyperpathia in isolation and the absence of sensory loss were considered minor risk factors. It is our hope that the criteria here established will improve patient selection and so, the overall results of DBS. |
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Risk factors for unpleasant paresthesiae induced by paresthesiae - producing deep brain stimulationpainanalgesiadeep brain stimulationelectrical stimulationparesthesiaestereotaxisthalamusthalamic nucleimedial lemniscusinternal capsuleParesthesiae-producing deep brain stimulation (stimulation of ventrocaudal nucleus - VC, medial lemniscus - ML or internal capsule - IC) is one of the few procedures to treat the steady element of neural injury pain (NIP) currently available. Reviewing the first 60 patients with NIP submitted to deep brain stimulation (DBS) from 1978 to 1991 at the Division of Neurosurgery, Toronto Hospital, University of Toronto, we observed that 6 patients complained of unpleasant paresthesiae with paresthesiae-producing DBS, preventing permanent electrode implantation in all of them. Such patients accounted for 15% of the failures (6 out of 40 failures) in our series. In an attempt to improve patient selection, we reviewed our patients considering a number of parameters in order to determine risk factors for unpleasant paresthesiae elicited by paresthesiae-producing DBS. The results showed that this response happenned only in patients with brain central pain complaining of evoked pain, secondary to a supratentorial lesion. Age, sex, duration of pain, quality of the steady pain, size of the causative lesion and site (VC,ML,IC) and type (micro or macroelectrode) of surgical exploration were not important factors. Unpleasant paresthesiae in response to dorsal column stimulation, restricted thalamic lesion on computed tomography and the occurrence of associated intermittent pain were considered major risk factors in this subset of patients and the presence of cold allodynia or hyperpathia in isolation and the absence of sensory loss were considered minor risk factors. It is our hope that the criteria here established will improve patient selection and so, the overall results of DBS.Academia Brasileira de Neurologia - ABNEURO1996-03-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X1996000100010Arquivos de Neuro-Psiquiatria v.54 n.1 1996reponame:Arquivos de neuro-psiquiatria (Online)instname:Academia Brasileira de Neurologiainstacron:ABNEURO10.1590/S0004-282X1996000100010info:eu-repo/semantics/openAccessVilela Filho,Osvaldoeng2010-12-07T00:00:00Zoai:scielo:S0004-282X1996000100010Revistahttp://www.scielo.br/anphttps://old.scielo.br/oai/scielo-oai.php||revista.arquivos@abneuro.org1678-42270004-282Xopendoar:2010-12-07T00:00Arquivos de neuro-psiquiatria (Online) - Academia Brasileira de Neurologiafalse |
dc.title.none.fl_str_mv |
Risk factors for unpleasant paresthesiae induced by paresthesiae - producing deep brain stimulation |
title |
Risk factors for unpleasant paresthesiae induced by paresthesiae - producing deep brain stimulation |
spellingShingle |
Risk factors for unpleasant paresthesiae induced by paresthesiae - producing deep brain stimulation Vilela Filho,Osvaldo pain analgesia deep brain stimulation electrical stimulation paresthesiae stereotaxis thalamus thalamic nuclei medial lemniscus internal capsule |
title_short |
Risk factors for unpleasant paresthesiae induced by paresthesiae - producing deep brain stimulation |
title_full |
Risk factors for unpleasant paresthesiae induced by paresthesiae - producing deep brain stimulation |
title_fullStr |
Risk factors for unpleasant paresthesiae induced by paresthesiae - producing deep brain stimulation |
title_full_unstemmed |
Risk factors for unpleasant paresthesiae induced by paresthesiae - producing deep brain stimulation |
title_sort |
Risk factors for unpleasant paresthesiae induced by paresthesiae - producing deep brain stimulation |
author |
Vilela Filho,Osvaldo |
author_facet |
Vilela Filho,Osvaldo |
author_role |
author |
dc.contributor.author.fl_str_mv |
Vilela Filho,Osvaldo |
dc.subject.por.fl_str_mv |
pain analgesia deep brain stimulation electrical stimulation paresthesiae stereotaxis thalamus thalamic nuclei medial lemniscus internal capsule |
topic |
pain analgesia deep brain stimulation electrical stimulation paresthesiae stereotaxis thalamus thalamic nuclei medial lemniscus internal capsule |
description |
Paresthesiae-producing deep brain stimulation (stimulation of ventrocaudal nucleus - VC, medial lemniscus - ML or internal capsule - IC) is one of the few procedures to treat the steady element of neural injury pain (NIP) currently available. Reviewing the first 60 patients with NIP submitted to deep brain stimulation (DBS) from 1978 to 1991 at the Division of Neurosurgery, Toronto Hospital, University of Toronto, we observed that 6 patients complained of unpleasant paresthesiae with paresthesiae-producing DBS, preventing permanent electrode implantation in all of them. Such patients accounted for 15% of the failures (6 out of 40 failures) in our series. In an attempt to improve patient selection, we reviewed our patients considering a number of parameters in order to determine risk factors for unpleasant paresthesiae elicited by paresthesiae-producing DBS. The results showed that this response happenned only in patients with brain central pain complaining of evoked pain, secondary to a supratentorial lesion. Age, sex, duration of pain, quality of the steady pain, size of the causative lesion and site (VC,ML,IC) and type (micro or macroelectrode) of surgical exploration were not important factors. Unpleasant paresthesiae in response to dorsal column stimulation, restricted thalamic lesion on computed tomography and the occurrence of associated intermittent pain were considered major risk factors in this subset of patients and the presence of cold allodynia or hyperpathia in isolation and the absence of sensory loss were considered minor risk factors. It is our hope that the criteria here established will improve patient selection and so, the overall results of DBS. |
publishDate |
1996 |
dc.date.none.fl_str_mv |
1996-03-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X1996000100010 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X1996000100010 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/S0004-282X1996000100010 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Academia Brasileira de Neurologia - ABNEURO |
publisher.none.fl_str_mv |
Academia Brasileira de Neurologia - ABNEURO |
dc.source.none.fl_str_mv |
Arquivos de Neuro-Psiquiatria v.54 n.1 1996 reponame:Arquivos de neuro-psiquiatria (Online) instname:Academia Brasileira de Neurologia instacron:ABNEURO |
instname_str |
Academia Brasileira de Neurologia |
instacron_str |
ABNEURO |
institution |
ABNEURO |
reponame_str |
Arquivos de neuro-psiquiatria (Online) |
collection |
Arquivos de neuro-psiquiatria (Online) |
repository.name.fl_str_mv |
Arquivos de neuro-psiquiatria (Online) - Academia Brasileira de Neurologia |
repository.mail.fl_str_mv |
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