[Treatment of chronic pain with intracerebral stimulators]

A new technique for the functional treatment of chronic intractable pain with a cerebral stimulation system under the patient's control is described. A four-pole electrode, diameter 0.65 mm (made by Medtronic), was implanted under stereotaxic control into nine patients. Stimulation was via a substernally implanted receiver connected to the intracerebral electrode. A pocket-sized stimulator with circular aerial, intermittently placed on the patient's skin, was activated by the patient whenever pain occurred. Pain suppression was achieved in all instances, best results being obtained with stimulation of the medial mesencephalic lemniscus, including the sensory-motor thalamic nuclei. The pain-suppressing effect lasted for up to seven hours, so that three stimulations for 30-40 minutes daily were sufficient, as demonstrated by an observation period of up to 21 months. The only complication was transitory oculomotor paresis. The described reversible non-destructive stereotaxic and functional technique of stimulation is preferable to the coagulation method in the treatment of chronic intractable pain.