Fax +41 61 306 12 34 E-Mail karger@karger.ch www.karger.com Clinical Study Stereotact Funct Neurosurg 2011;89:83–88 DOI: 10.1159/000323338 Motor Cortex Stimulation for Trigeminal Neuropathic or Deafferentation Pain: An Institutional Case Series Experience Ahmed M. Raslan Morad Nasseri Diaa Bahgat Emun Abdu Kim J. Burchiel  Department of Neurological Surgery, Oregon Health & Science University, Portland, Oreg., USA pain control). Patients with anesthesia dolorosa or trigemi- nal deafferentation pain who had previously undergone ab- lative trigeminal procedures responded poorly to MCS. We encountered no perioperative complications. Conclusion: MCS is a safe and potentially effective therapy in certain pa- tients with trigeminal neuropathy. Copyright © 2011 S. Karger AG, Basel Introduction Trigeminal neuropathy is characterized by constant, severe pain, as well as sensory deficits in the distribution of the trigeminal nerve, which are related to disease of, or injury to, the trigeminal nerve or ganglion. According to Burchiel’s [1] previous facial pain classification, trigem- inal neuropathy can result from unintentional injury to the trigeminal system, e.g. from facial trauma, oral surgery, ear, nose and throat surgery, root injury from posterior fossa or skull base surgery, stroke, and rarely idiopathic trigeminal neuropathy, and is classified as tri- geminal neuropathic pain (TNP), or it can result from intentional injury to the trigeminal system, e.g. from neu- rectomy, gangliolysis, rhizotomy, nucleotomy, tractoto- my or other denervating procedures and is classified as trigeminal deafferentation pain (TDP) [1]. Key Words Motor cortex stimulation  Trigeminal neuropathy  Trigeminal neuropathic pain  Trigeminal deafferentation pain Abstract Background: Trigeminal neuropathy is a rare, devastating condition that can be intractable and resistant to treatment. When medical treatment fails, invasive options are limited. Motor cortex stimulation (MCS) is a relatively recent tech- nique introduced to treat central neuropathic pain. The use of MCS to treat trigeminal neuropathic or deafferentation pain is not widespread and clinical data in the medical litera- ture that demonstrate efficacy are limited. Method: We ret- rospectively reviewed patients with trigeminal neuropathic or trigeminal deafferentation pain who were treated at the Oregon Health & Science University between 2001 and 2008 by 1 neurosurgeon using MCS. Results: Eight of 11 patients (3 male, 8 female) underwent successful permanent implan- tation of an MCS system. All 8 patients reported initial satis- factory pain control. Three failed to experience continued pain control (6 months of follow-up). Five continued to experience long-term pain control (mean follow-up, 33 months). Average programming sessions were 2.2/year (all 8 patients) and 1.55/year (5 patients who sustained long-term Received: September 2, 2010 Accepted after revision: November 28, 2010 Published online: February 2, 2011 Kim J. Burchiel, MD, FACS Neurological Surgery, CH8N, Oregon Health & Science University 3303 SW Bond Ave Portland, OR 97239 (USA) Tel. +1 503 494 4314, Fax +1 503 346 6810, E-Mail burchiek  @  ohsu.edu © 2011 S. Karger AG, Basel 1011–6125/11/0892–0083$38.00/0 Accessible online at: www.karger.com/sfn