Erratum: Motor Cortex Stimulation for Trigeminal Neuropathic or Deafferentation Pain: An Institutional Case Series Experience

<i>Background:</i> 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 technique 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 literature that demonstrate efficacy are limited. <i>Method:</i> We retrospectively reviewed patients with trigeminal neuropathic or trigeminal deafferentation pain who were treated at the Oregon Health &amp; Science University between 2001 and 2008 by 1 neurosurgeon using MCS. <i>Results:</i> Eight of 11 patients (3 male, 8 female) underwent successful permanent implantation of an MCS system. All 8 patients reported initial satisfactory 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 pain control). Patients with anesthesia dolorosa or trigeminal deafferentation pain who had previously undergone ablative trigeminal procedures responded poorly to MCS. We encountered no perioperative complications. <i>Conclusion:</i> MCS is a safe and potentially effective therapy in certain patients with trigeminal neuropathy.

背景：
三叉神经病变（Trigeminal neuropathy）是一种罕见且极具破坏性的疾病，往往病程顽固、对常规治疗存在抵抗性。当药物治疗无效时，可供选择的有创治疗手段十分有限。运动皮层刺激（Motor cortex stimulation, MCS）是近年问世的用于治疗中枢神经性疼痛的新技术。但将MCS应用于三叉神经性疼痛或三叉神经去传入疼痛的治疗尚未普及，医学文献中能够证实其疗效的临床数据也较为匮乏。
方法：
本研究回顾性分析了2001年至2008年间，在俄勒冈健康与科学大学（Oregon Health & Science University）由同一名神经外科医生采用MCS治疗的三叉神经性疼痛或三叉神经去传入疼痛患者的临床资料。
结果：
11例患者中，8例成功植入永久性MCS系统（其中男性3例，女性8例）。所有8例患者均报告初始疼痛控制效果满意。其中3例在随访6个月后未能维持持续的疼痛控制，剩余5例实现了长期疼痛控制（平均随访时长33个月）。全部8例患者的平均程控次数为每年2.2次，实现长期疼痛控制的5例患者平均程控次数为每年1.55次。既往接受过三叉神经毁损性手术的痛性麻木（anesthesia dolorosa）或三叉神经去传入疼痛患者，对MCS的治疗响应效果不佳。本研究未出现任何围手术期并发症。
结论：
MCS对于部分三叉神经病变患者而言，是一种安全且具有潜在疗效的治疗手段。