Pressure pain assessment may predict the outcome of spinal cord stimulation for refractory epilepsy

It was well-documented that epilepsy and pain arise from an excitation-inhibition imbalance within neuronal networks. A previous meta-analysis of data from clinical trials showed an association between anticonvulsants and specific pain types, e.g. multiple sclerosis pain. Multiple multicentre randomized controlled trials have shown that antiepileptic drugs have a prominent role in the treatment of several types of pain, e.g. neuropathic pain. Many anticonvulsants have been introduced to better manage acute postoperative pain, with improvements in analgesic efficacy and safety. These data suggested that there existed the similar mechanisms of certain forms of epilepsy and pain, and the therapeutic mechanism of spinal cord stimulation for certain forms of epilepsy and pain may be involved in the melanocortinergic signaling, and the change in cerebral glucose metabolism. We hypothesized that pressure pain assessment may predict the outcome of spinal cord stimulation in refractory epilepsy.