Motor cortex stimulation is a type of medical surgery which is done to reduce chronic pain. If the patient is having trigeminal neuralgia (TN) that does not get better with other treatments, the doctor might suggest motor cortex stimulation.
With this procedure, the doctor uses small electrodes (wires that conduct mild electrical signals) to stimulate areas of the patient’s brain. The procedure stimulates areas that move patient’s face, neck, trunk (middle of the body), arms and leg.
What is the goal of Motor cortex stimulation?
The trigeminal neuropathic facial pain and post-stroke pain which is faced during this medical issue, can be relieved through non-surgical methods such as oral medications, injections, and nerve blocks. When these non-surgical options fail and severe pain turns into a chronic condition, motor cortex stimulation may be the next step.
Significantly, this process doesn’t act as an aid for pain but Motor cortex stimulation can help in relieving symptoms and decrease the number of medications that the patient is taking. It can also take up to 6 months of adjustments after the surgery to reach optimal results.
The procedure of Motor cortex stimulation
Before surgery, the doctor locates the specific area of the patient’s brain that produces movements in various parts of the body. The doctor may use one of several different techniques to locate this area.
Motor cortex stimulation surgery is usually performed under general anesthesia (the patient is asleep during the procedure).
A surgeon performs a craniotomy (opens the patient’s skull to expose his brain) and inserts an electrode into the tough membrane covering the brain. The doctor uses the electrode to stimulate the part of the patient’s brain that controls movement. At the same time,a surgeon is alert to see if any of the patient’s muscles contract (tighten).
The electrode stimulation during surgery may completely relieve the patient’s pain. However, the patient generally has longer trial stimulation before his doctor implants a pulse generator.
After the Motor cortex stimulation
The doctor tests the electrode as soon as the patient is fully awake. The patient will have tests until he can confirm that stimulation has reduced the pain he had before surgery, by at least 50 percent (half as painful as before surgery).
The patient will need a second craniotomy, conducted under general anesthesia, for a doctor to permanently implant a pulse generator. The pulse generator is usually placed under the skin of the patient’s chest, often near his collarbone. It is permanently connected to the electrode.
Risks of motor cortex stimulation
Risks related to this procedure include:
- Seizures during surgery
- Infection around the stimulator or pulse generator
- Epidural hematoma (blood buildup between the skull and brain covering)
- Subdural effusion (fluid release under the brain covering)
- Pain relief that gets less over time
- Pain caused by the stimulation
Be sure to talk to the doctor about the risks of this procedure in patient’s particular condition.
Which are the different tests that have to be performed before Motor Cortex Stimulation?
Some of the tests that should be performed before Motor Cortex Stimulation:
- Blood Pressure Test