THERAPEUTIC STEREOTAXIC PROCEDURES ON THE THALAMUS FOR PAIN

Thalamotomy and electrical stimulation of a thalamic target as treatme nt for persistent pain are discussed. Thalamotomy is only rarely perfo rmed these days according to a questionnaire, given to some colleagues , about the type and the number of operations they performed in the ye ars 1984, 1985 and 1986. The need for stimulation in the periventricul ar or periaqueductal grey for nociceptive pain is decreasing due to th e advent of intraspinal and intraventricular administration of opioids . Nowadays medial and lateral ventro-posterior thalamic nuclei are fre quently stimulated for treatment of deafferentation pain. Of 36 patien ts with deafferentation pain, 22 initially had benefit from this stimu lation, but long-term success was only achieved in 11 (30%) of them. I t was a general trend that the patients with an initial high pain reli ef score obtained the best long-term results.