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Jeffrey A. Brown, M.D. - External versus internal stimulation |
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Tony Whitworth, M.D. - Neurostimulation for neuropathic facial pain |
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Konstantin Slavin, M.D. - How stimulation works on neuropathic pain |
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Konstantin Slavin, M.D. - Criteria for Peripheral vs. Motor Cortex Stimulation for neuropathic pain patients |
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Tony Whitworth, M.D. - Stimulation and insurance coverage |
Neurostimulation
Neurostimulation is used to help neuropathic pain patients. It is considered after medication and other medical or alternative treatments are unsuccessful in controlling pain. Fortunately, it does no further injury to the nerve. The exact mechanism is unknown but is theorized to interfere with the transmission of the pain signals
Psychological testing may be done prior to electrode insertion to verify a patient’s goals and expected outcome (probably pain improvement, but seldom complete pain elimination).
Transcranial magnetic stimulation (TMS) is sometimes used as a pretest because a positive response to TMS may predict a more positive response to neurostimulation procedures.
Neurostimulation involves placement of an electrode(s) connected to a power source (a battery) through which electric current is passed to stimulate the nerve. After electrode placement, a trial period allows for programming the stimulator to achieve 50% or more in pain relief. When the trial is successful, a wire is placed under the skin connecting the electrodes to an implanted battery much like a pacemaker battery. There is no guarantee of successful use of the stimulator after implantation.
EFNS guidelines on neurostimulation therapy for neuropathic pain
http://www.guideline.gov/summary/summary.aspx?doc_id=11372
Electrodes in brain fight pain
http://www.sfgate.com/cgi-bin/article.cgi?file=/chronicle/archive/2002/05/06/MN136466.DTL
Neurostimulation for the treatment of chronic pain
http://thejns.org/doi/pdf/10.3171/foc.2006.21.6.12
TNA Review of Neuropathic Facial Pain
http://www.fpa-support.org/learning/ReviewofNeuropathicPain2.html
Organizations
None
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