SAGE Journals Online
Advertisement
Sign In to gain access to subscriptions and/or personal tools.

 

Advanced Search

Journal Navigation

Journal Home

Subscriptions

Archive

Contact Us

Table of Contents

Advertisement

Sign In to gain access to subscriptions and/or personal tools.
Multiple Sclerosis
This Article
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
1352458509107018v1
15/11/1322    most recent
Right arrow References
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Saved Citations
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Request Reprints
Right arrow Add to My Marked Citations
Citing Articles
Right arrow Citing Articles via Scopus
Google Scholar
Right arrow Articles by Cordella, R.
Right arrow Articles by Broggi, G.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Cordella, R.
Right arrow Articles by Broggi, G.
Social Bookmarking
Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

Hypothalamic stimulation for trigeminal neuralgia in multiple sclerosis patients: efficacy on the paroxysmal ophthalmic pain

R. Cordella

Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy

A. Franzini

Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy, bsvjf{at}tin.it

L. La Mantia

Department of Neurology, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy

C. Marras

Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy

A. Erbetta

Department of Radiology, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy

G. Broggi

Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy

Trigeminal neuralgia is a disorder characterized by paroxysmal pain arising in one or more trigeminal branches; it is commonly reported in multiple sclerosis. In multiple sclerosis patients the ophthalmic branch may be frequently involved and the risks carried by neurosurgical ablative procedures are higher including major adverse effects such as corneal reflex impairment and keratitis. The objective of this works is to assess the role of posterior hypothalamus neuromodulation in the treatment of trigeminal neuralgia in multiple sclerosis patients. Five multiple sclerosis patients suffering from refractory recurrent trigeminal neuralgia involving all three trigeminal branches underwent deep brain stimulation of the posterior hypothalamus. The rationale of this intervention emerges from our earlier success in treating pain patients suffering from trigeminal autonomic cephalalgias. After follow-up periods that ranged from 1 to 4 years after treatment, the paroxysmal pain arising from the first trigeminal branch was controlled, whereas the recurrence of pain in the second and third trigeminal branches necessitated repeated thermorhizotomies to control in pain in two patients after 2 years of follow-up. In conclusion, deep brain stimulation may be considered as an adjunctive procedure for treating refractory paroxysmal pain within the first trigeminal division so as to avoid the complication of corneal reflex impairment that is known to follow ablative procedures.

Key Words: deep brain stimulation • multiple sclerosis • pain • posterior hypothalamus • trigeminal neuralgia

This version was published on November 1, 2009

Multiple Sclerosis, Vol. 15, No. 11, 1322-1328 (2009)
DOI: 10.1177/1352458509107018
Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?




Advertisement