The correlation of pain relief, neurological sign, EEG and anatomical lesion sites in pain patients treated by stereotaxic thalamotomy.

Abstract

SummaryThe clinical syndromes are described on the basis of an anatomical correlation in nine patients who have had stereotaxic thalamotomy for the relief of intractable pain. The cases who have bilateral lesions in the ventroposterior parts of CEM get excellent pain relief without any kind of serious complication. The case who has lesions in the VPM is characterized by sensory loss with temporary pain relief. However, bilateral lesion group is characterized by psychiatric syndrome and slow wave bursts in EEG. The Pf‐pretectal lesion group has serious complications which include unconsciousness, extrapyramidal motor effect and slow wave bursts in EEG.This result indicates that the ventroposterior parts of CEM have an important role in perceiving pain sensation but have not chief role in maintaining consciousness and altering EEG. To make lesion of the bilateral CEM is most suitable operation in order to relief of intractable pain caused by malignant tumor.