Estimulación de la corteza motora para el dolor facial crónico neuropático. Revisión de la literatura
Motor cortex stimulation for facial chronic neuropathic pain: A review of the literature.
Monsalve GA.
Departamento de Neurocirugía, Clínica Nueva, Bogotá D.C., Bogotá D.C., Colombia.
Surg Neurol Int. 2012;3(Suppl 4):S290-311. doi: 10.4103/2152-7806.103023. Epub 2012 Oct 31.
Abstract
BACKGROUND: Facial chronic neuropathic pain (FCNP) is a disabling clinical entity, its incidence is increasing within the chronic pain population. There is indication for neuromodulation when conservative treatment fails. Motor cortex stimulation (MCS) has emerged as an alternative in the advanced management of these patients. The aim of this work is to review the worldwide literature on MCS for FCNP. METHODS: A PubMed search from 1990 to 2012 was conducted using established MeSH words. A total of 126 relevant articles on MCS focused on chronic pain were selected and analysed. Series of cases were divided in (1) series focused on MCS for FCNP, and (2) MCS series of FCNP mixed with other chronic pain entities. RESULTS: A total of 118 patients have been trialed for MCS for FCNP, 100 (84.7%) pursued permanent implantation of the system, and 84% of them had good pain control at the end of the study. Male: female ratio was about 1:2 in the whole group of studies; mean age was 58 years (range, 28-83), and mean pain duration was 7 years (range, 0.6-25). Four randomized controlled studies have been reported, all of them not focused on MCS for FCNP. The most common complication was seizure followed by wound infection. Preoperative evaluation, surgical techniques, and final settings varied among the series. CONCLUSION: MCS for FNCP is a safe and efficacious treatment option when previous managements have failed; however, there is still lack of strong evidence (larger randomized controlled multicentre studies) that MCS can be offered in a regular basis to FNCP patients.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3514920/
Dolor facial: neurológico y no neurológico
Facial Pain:NEUROLOGICAL AND NON-NEUROLOGICAL
Joanna M Zakrzewska
J Neurol Neurosurg Psychiatry 2002;72(Suppl II):ii27-ii32
Pain in the facial area may be due to neurological or vascular causes, but equally well may be dental in origin. The patient will often make the first attempt at diagnosis in that he or she chooses to consult either the dentist or the doctor. This may therefore lead to inappropriate diagnosis and treatment. Many patients with trigeminal neuralgia complain that their dentist treated them for dental causes of pain before finally they received the correct diagnosis. This is, however, highly understandable as dental pain is extremely common whereas trigeminal neuralgia is a rare condition and primary care medical and dental practitioners may only see three or four cases in their practising lifetime. All the neurological and vascular causes of facial pain (excluding headaches) are rare compared to the dental and temporomandibular causes. The risk factors for some of the conditions are known, but there is little information on natural history and prognosis. Further details of the epidemiology of facial pain can be found in Epidemiology of pain, which has been written using evidence based methodology.
http://jnnp.bmj.com/content/72/suppl_2/ii27.full.pdf+html
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Motor cortex stimulation for facial chronic neuropathic pain: A review of the literature.
Monsalve GA.
Departamento de Neurocirugía, Clínica Nueva, Bogotá D.C., Bogotá D.C., Colombia.
Surg Neurol Int. 2012;3(Suppl 4):S290-311. doi: 10.4103/2152-7806.103023. Epub 2012 Oct 31.
Abstract
BACKGROUND: Facial chronic neuropathic pain (FCNP) is a disabling clinical entity, its incidence is increasing within the chronic pain population. There is indication for neuromodulation when conservative treatment fails. Motor cortex stimulation (MCS) has emerged as an alternative in the advanced management of these patients. The aim of this work is to review the worldwide literature on MCS for FCNP. METHODS: A PubMed search from 1990 to 2012 was conducted using established MeSH words. A total of 126 relevant articles on MCS focused on chronic pain were selected and analysed. Series of cases were divided in (1) series focused on MCS for FCNP, and (2) MCS series of FCNP mixed with other chronic pain entities. RESULTS: A total of 118 patients have been trialed for MCS for FCNP, 100 (84.7%) pursued permanent implantation of the system, and 84% of them had good pain control at the end of the study. Male: female ratio was about 1:2 in the whole group of studies; mean age was 58 years (range, 28-83), and mean pain duration was 7 years (range, 0.6-25). Four randomized controlled studies have been reported, all of them not focused on MCS for FCNP. The most common complication was seizure followed by wound infection. Preoperative evaluation, surgical techniques, and final settings varied among the series. CONCLUSION: MCS for FNCP is a safe and efficacious treatment option when previous managements have failed; however, there is still lack of strong evidence (larger randomized controlled multicentre studies) that MCS can be offered in a regular basis to FNCP patients.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3514920/
Dolor facial: neurológico y no neurológico
Facial Pain:NEUROLOGICAL AND NON-NEUROLOGICAL
Joanna M Zakrzewska
J Neurol Neurosurg Psychiatry 2002;72(Suppl II):ii27-ii32
Pain in the facial area may be due to neurological or vascular causes, but equally well may be dental in origin. The patient will often make the first attempt at diagnosis in that he or she chooses to consult either the dentist or the doctor. This may therefore lead to inappropriate diagnosis and treatment. Many patients with trigeminal neuralgia complain that their dentist treated them for dental causes of pain before finally they received the correct diagnosis. This is, however, highly understandable as dental pain is extremely common whereas trigeminal neuralgia is a rare condition and primary care medical and dental practitioners may only see three or four cases in their practising lifetime. All the neurological and vascular causes of facial pain (excluding headaches) are rare compared to the dental and temporomandibular causes. The risk factors for some of the conditions are known, but there is little information on natural history and prognosis. Further details of the epidemiology of facial pain can be found in Epidemiology of pain, which has been written using evidence based methodology.
http://jnnp.bmj.com/content/72/suppl_2/ii27.full.pdf+html
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
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