Stereotaxic Thalamotomy for Pain Relief

Abstract

As a preliminary experimental study, the activity of single units of the thalamic pulvinar nucleus was studied in cats, and it was found that some of the pulvinar neurons responded to nociceptive stimuli such as pinpricks with a needle and pinching with toothed forceps. Clinically, the destruction of the thalamic pulvinar nuclei was performed in 17 patients with chronic severe pain by the use of the stereotaxic surgical technique. Out of these 17 patients, 6 suffered from postcerebrovascular accident, 9 from infiltration and metastasis of cancer, and 2 from atypical facial pain and trigeminal neuralgia. Complete relief of pain without appreciable sensory loss was obtained in 10 patients, and fairly good effects of pain relief in 7 patients. Transient emotional change was elicited in 12 patients, but this change disappeared 4-20 days after the operation. Thereafter these patients became normal in emotion and personality. © 1968, Tohoku University Medical Press. All rights reserved.