The Central Lateral Thalamotomy for Neuropathic Pain

Abstract

Head and Holmes postulated in 1911 the existence of an “essential medial thalamic centre,” localized medial to a pain-generating lesion in the thalamic ventroposterior (VP) nucleus, and responsible for the pathogenesis of central pain [1]. This centre was thought to be exposed to a decreased inhibitory influence from thalamo-cortico-thalamic loops. A generation of abnormal impulses in VP and their amplification in a reverberating circuit between lateral and medial thalamic nuclei were also proposed in the seventies by Sano [2]. Furthermore, the medial thalamus has been known for years to be an amplifier/synchronizer for low electroencephalographic (EEG) frequencies [3].