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Updated: Jul 4, 2026
09:35
Subcutaneous Trigeminal Nerve Field Stimulation for Refractory Facial Pain
Published on: May 10, 2017
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Motor Cortex Stimulation for Refractory Trigeminal Pain: A Case Series from Atlantic Canada
Jacob Saucier1,2, Lyndon Boone3, Simon Elsliger2,4
1Division of Neurology, Department of Medicine, Université de Montreal, Montreal, Quebec, Canada.
Summary
Motor cortex stimulation (MCS) effectively treats intractable trigeminal neuropathy (PTN) pain. This neuromodulation technique significantly reduces facial pain and opioid use in refractory cases.
Area of Science:
- Neurology
- Neurosurgery
- Pain Management
Background:
- Neuromodulation is an emerging treatment for intractable pain.
- Motor cortex stimulation (MCS) shows efficacy for chronic orofacial pain.
- Painful trigeminal neuropathy (PTN) presents a significant challenge in refractory cases.
Purpose of the Study:
- To evaluate the effectiveness of MCS in patients with refractory PTN.
- To assess pain reduction and opioid consumption following MCS implantation.
Main Methods:
- Retrospective case series of five patients with refractory PTN treated with MCS.
- Outcomes measured included Visual Analogue Scale (VAS) for pain and morphine equivalent dose (MED).
- Follow-up assessments at 6 and 12 months post-operation.
Main Results:
- All five patients achieved primary (≥50% VAS reduction) and secondary (≥60% MED reduction) outcomes.
- Mean VAS decreased by 77% at 12 months post-MCS.
- Average MED/day reduced by 93%, with 80% of patients opioid-free by 18 months.
Conclusions:
- MCS demonstrates significant potential for long-term pain relief in refractory trigeminal pain.
- MCS can substantially reduce opioid consumption.
- Further large-scale multicenter trials are warranted.
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