[Stereotaxic thalamotomy in the phantom pain syndrome]

The results of stereotaxic thalamotomy in 18 patients suffering from a severe phantom-pain syndrome are described. It is shown that to achieve a more stable analgetic effect and a reduced emotional background of pain perception it is expedient, parallel with the destruction of the somatotopic zones of the relay posterior ventral nucleus, which have a bearing on pains in the phantom, to also exclude the non-specific afferent systems of the thalamus, that is, the median center, bordering nucleus and oroventral part of the cushion of the optic thalamus. The effects of the electrostimulation of these structures of the thalamus are described in the process of their intraoperational physiological identification. It is shown that the combined destruction of specific and non-specific afferent structures of the optic thalamus in most cases ensures a considerable diminution or disappearance of phantom pain permitting patients to readapt themselves to normal everyday life.