Yamgoue Yves, Pralong Etienne, Levivier Marc, Bloch Jocelyne
Service of Neurosurgery, Centre hospitalier universitaire vaudois (CHUV), Lausanne, Switzerland.
Stereotact Funct Neurosurg. 2016;94(2):118-22. doi: 10.1159/000444762. Epub 2016 Apr 21.
We report the successful treatment of recurrent facial pain by deep brain stimulation (DBS) of the ventroposteromedial thalamic nucleus (VPM-DBS), 10 years after VPM thalamotomy. A 62-year-old woman who suffered from an atypical right-sided trigeminal neuralgia of the V1 and V2 branches was successfully treated a decade ago with a radiofrequency VPM thermocoagulation. Ten years later, the same burning right-sided trigeminal pain progressively recurred and was resistant to medical treatments. A DBS procedure was proposed to the patient aiming to stimulate the vicinity of the preexisting stereotactic lesion. Intraoperatively, the pain relief was immediate at low stimulation intensities. Eleven months later, the patient remains pain free. This case report suggests that DBS targeting an area of the VPM close to the previous stereotactic lesion is possible as a salvage therapy, and can successfully achieve relief of facial pain 10 years after VPM thalamotomy.
我们报告了在丘脑腹后内侧核深部脑刺激（VPM-DBS）治疗复发性面部疼痛的成功案例，该患者在接受VPM丘脑切开术10年后进行了此治疗。一名62岁女性，患有非典型右侧三叉神经V1和V2分支疼痛，十年前通过射频VPM热凝术成功治疗。十年后，同样的右侧烧灼样三叉神经痛逐渐复发，且对药物治疗无效。遂向患者提议进行DBS手术，旨在刺激先前立体定向病变附近区域。术中，在低刺激强度下疼痛立即缓解。11个月后，患者仍无疼痛。该病例报告表明，以靠近先前立体定向病变的VPM区域为靶点进行DBS作为挽救治疗是可行的，并且可以在VPM丘脑切开术10年后成功缓解面部疼痛。
