Tasker R R, Vilela Filho O
Toronto Hospital, Western Division, Division of Neurosurgery, Ont., Canada.
Stereotact Funct Neurosurg. 1995;65(1-4):122-4. doi: 10.1159/000098682.
Paresthesia-producing (PP), but not periventricular grey (PVG) deep brain stimulation (DBS) proved effective in steady neuropathic pain in 25 patients receiving both, regardless of the PP site stimulated, but PVG-DBS suppressed allodynia or hyperpathia in 3 cases of stroke-induced pain. In patients with stroke-induced central pain, PP-DBS was unpleasant in 6 of 17 (35%), all with allodynia and/or hyperpathia, but not in patients with spinal cord central or peripheral neuropathic pain with allodynia or hyperpathia. Of 11 patients in whom prior ineffective dorsal column stimulation (DCS) produced appropriate paresthesia, none responded to PP-DBS; 5 of 7 did so in whom DCS produced no paresthesia or relieved pain. Periaqueductal grey DBS was nearly always unpleasant, PVG-DBS sometimes was.
在25例接受两种深部脑刺激（DBS）的患者中，产生感觉异常（PP）的DBS而非脑室周围灰质（PVG）的DBS被证明对稳定的神经性疼痛有效，无论刺激的PP部位如何，但PVG-DBS在3例中风后疼痛患者中抑制了异常性疼痛或痛觉过敏。在中风后中枢性疼痛患者中，17例中有6例（35%）接受PP-DBS时感到不适，均伴有异常性疼痛和/或痛觉过敏，但在伴有异常性疼痛和/或痛觉过敏的脊髓中枢或周围神经性疼痛患者中则没有。在11例先前无效的背柱刺激（DCS）产生适当感觉异常的患者中，无人对PP-DBS有反应；在7例DCS未产生感觉异常或缓解疼痛的患者中，有5例有反应。导水管周围灰质DBS几乎总是令人不适的，PVG-DBS有时会令人不适。
