Contribution of thalamotomy, cordotomy and << dorsal root entry zone >> (DREZ) caudalis trigeminalis lesions in the treatment of chronic pain

<<Ablative>> neurosurgical methods are mainly proposed in cases of nocicept ive pain, but at present, medical treatments and local pharmacotherapy (int rathecal and intracerebroventricular) are often very effective in this cont ext. Moreover, neurophathic pain is well controlled by <<augmentative>> tec hniques, except painful paroxysms. If a destructive method is necessary, it is selective, performed according to precise neurophysiological and anatom ical data with the frequent use of percutaneous and/or sterotactic techniqu es : the lesion of caudalis DREZ in treatment of neurophathic trigeminal pa in, the antero-lateral cordotomy in the treatment of unilateral severe canc er pain and several kinds of thalamotomy.