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Motor cortex stimulation for phantom limb pain treatment.
Walter Fagundes1, Kaike Lobo2, Numa Rajab2
1Department of Neurosurgery, Federal University of Espirito Santo, Vitoria, Espirito Santo, Brazil.
Surgical Neurology International
|March 5, 2025
Summary
Motor cortex stimulation (MCS) offers a promising treatment for phantom limb pain (PLP), a challenging neuropathic condition. This study shows MCS effectively reduced pain and medication intake in refractory PLP patients.
Area of Science:
- Neurosurgery
- Pain Management
- Neurology
Background:
- Phantom limb pain (PLP) is a chronic neuropathic pain syndrome post-amputation.
- Pharmacological treatments often fail to provide adequate relief for PLP.
- Motor cortex stimulation (MCS) is an emerging therapeutic option for refractory PLP.
Purpose of the Study:
- To evaluate the efficacy of epidural motor cortex stimulation (MCS) in managing chronic, refractory phantom limb pain (PLP).
Main Methods:
- Three patients with chronic, refractory PLP underwent epidural MCS implantation.
- Electrode placement guided by stereotactic angiography and 3D-MRI.
- Pain intensity assessed using Visual Analog Scale (VAS) over a mean 7-month follow-up.
Main Results:
- Two patients experienced a >50% reduction in pain; one had a 44.4% reduction.
- Average VAS scores significantly decreased from 7.0 to 3.67 (P=0.00985).
- All patients reduced analgesic medication intake with no major complications.
Conclusions:
- Motor cortex stimulation (MCS) is an effective and adjustable treatment for chronic PLP refractory to other methods.
- MCS provides a reversible therapeutic option for challenging neuropathic pain conditions.
