[Motor cortex stimulation in the central pain syndrome]

We present a case of a 45-year-old male, treated with motor cortex stimulation (MCS). The procedure was performed in order to decrease symptoms of the central pain syndrome (CPS), which developed seven years earlier, after a left-side, cerebellum and brainstem ischemic stroke. The syndrome is defined as pain due to primary damage or dysfunction of the central nervous system. The pain was not sensitive to pharmacological and previous surgical interventions. During four months of follow-up after surgery with the use of MCS, 20% reduction of pain (Visual Analog Scale), withdrawal of narcotic and decrease of non-narcotic medications, ability to introduce rehabilitation and improvement of sleep were observed. No side effects were noticed. The procedure of electrode implantation to motor cortex is a relatively new treatment option in refractory central and neuropathic pain syndromes. The number of described procedures does not exceed 500 worldwide. The presented case is to our knowledge the first procedure of its type in Poland, giving hope to CPS patients, whose symptoms are otherwise difficult to treat.