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Contralateral mirror-image pain following anterolateral cordotomy
1Pain Relief Foundation, Department of Neurological Sciences, University of Liverpool, Liverpool L9 1AE U.K.
Pain
|April 1, 1988
Summary
Anterolateral cordotomy can cause mirror-image pain by disrupting descending inhibitory control over nociceptive neurons. This pain mechanism may involve enkephalinergic interneurons, as suggested by naloxone injection results.
Area of Science:
- Neuroscience
- Pain Management
- Spinal Cord Surgery
Background:
- Anterolateral cordotomy is a surgical procedure to alleviate pain.
- Mirror-image pain is a paradoxical side effect observed after cordotomy.
- The underlying mechanisms of this phenomenon require further elucidation.
Purpose of the Study:
- To propose a hypothesis explaining mirror-image pain post-anterolateral cordotomy.
- To investigate the role of descending inhibitory pathways in pain perception.
- To explore the potential involvement of enkephalinergic interneurons.
Main Methods:
- Hypothetical model based on neuroanatomy of nociceptive neurons.
- Clinical observation of patients undergoing anterolateral cordotomy.
- Pharmacological intervention using naloxone to assess opioid pathway involvement.
Main Results:
- Hypothesized that some nociceptive neurons have bilateral receptive fields.
- Proposed that cordotomy lesions can impair descending inhibitory control.
- Naloxone administration suggested involvement of enkephalinergic interneurons in the inhibitory mechanism.
Conclusions:
- Mirror-image pain may result from disruption of descending inhibition on nociceptive pathways.
- Enkephalinergic interneurons are implicated in the normal tonic inhibitory control.
- Understanding these mechanisms could refine pain management strategies.