[A case of myogenic intractable pain due to thalamic hemorrhage relieved by Vim-Vo thalamotomy]. 1995

M Seike, and H Nishimura, and Y Ono, and M Kurisaka, and K Mori, and T Hirai
Department of Neurosurgery, Kochi Medical School, Japan.

A 58-year-old female patient with myogenic intractable pain due to thalamic hemorrhage which was relieved by stereotactic Vim-Vo thalamotomy was reported. She had an intractable pain, involuntary movement and deep sensory disturbance in her right arm. We performed stereotactic Vim-Vo thalamotomy using electrophysiological technique to relieve her involuntary movement and myogenic intractable pain. The electrophysiological recordings suggested the followings: (1) The destructive lesion by thalamic hemorrhage was located on from posterior border of Vim nucleus to the upper half of Vc nucleus. (2) Most of Vim neurons remained as intact state. (3) Thalamic electrical activities were relatively enhanced in the Vim nucleus. From these data, we can deduce that the deep sensory inputs reach the border area of Vim nucleus and Vc nucleus in the human thalamus. IMP-SPECT scans were performed before and after the operation. IMP-SPECT scan before operation showed us the contra-lateral cerebellar low perfusional state (crossed cerebellar diaschisis). This crossed cerebellar diaschisis disappeared after the operation. This result suggested that the interaction of cerebellum and Vim nucleus was very close. The above mentioned speculation was more compatible to Jones & Hirai's new parcellation of the human thalamus than to Hassler's.

UI MeSH Term Description Entries
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009135 Muscular Diseases Acquired, familial, and congenital disorders of SKELETAL MUSCLE and SMOOTH MUSCLE. Muscle Disorders,Myopathies,Myopathic Conditions,Muscle Disorder,Muscular Disease,Myopathic Condition,Myopathy
D010148 Pain, Intractable Persistent pain that is refractory to some or all forms of treatment. Refractory Pain,Intractable Pain,Intractable Pains,Pain, Refractory,Pains, Intractable,Pains, Refractory,Refractory Pains
D002543 Cerebral Hemorrhage Bleeding into one or both CEREBRAL HEMISPHERES including the BASAL GANGLIA and the CEREBRAL CORTEX. It is often associated with HYPERTENSION and CRANIOCEREBRAL TRAUMA. Brain Hemorrhage, Cerebral,Cerebral Parenchymal Hemorrhage,Hemorrhage, Cerebral,Intracerebral Hemorrhage,Hemorrhage, Cerebrum,Brain Hemorrhages, Cerebral,Cerebral Brain Hemorrhage,Cerebral Brain Hemorrhages,Cerebral Hemorrhages,Cerebral Parenchymal Hemorrhages,Cerebrum Hemorrhage,Cerebrum Hemorrhages,Hemorrhage, Cerebral Brain,Hemorrhage, Cerebral Parenchymal,Hemorrhage, Intracerebral,Hemorrhages, Cerebral,Hemorrhages, Cerebral Brain,Hemorrhages, Cerebral Parenchymal,Hemorrhages, Cerebrum,Hemorrhages, Intracerebral,Intracerebral Hemorrhages,Parenchymal Hemorrhage, Cerebral,Parenchymal Hemorrhages, Cerebral
D004594 Electrophysiology The study of the generation and behavior of electrical charges in living organisms particularly the nervous system and the effects of electricity on living organisms.
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013238 Stereotaxic Techniques Techniques used mostly during brain surgery which use a system of three-dimensional coordinates to locate the site to be operated on. Stereotactic Techniques,Stereotaxic Technics,Stereotactic Technique,Stereotaxic Technic,Stereotaxic Technique,Technic, Stereotaxic,Technics, Stereotaxic,Technique, Stereotactic,Technique, Stereotaxic,Techniques, Stereotactic,Techniques, Stereotaxic
D013786 Thalamic Diseases Disorders of the centrally located thalamus, which integrates a wide range of cortical and subcortical information. Manifestations include sensory loss, MOVEMENT DISORDERS; ATAXIA, pain syndromes, visual disorders, a variety of neuropsychological conditions, and COMA. Relatively common etiologies include CEREBROVASCULAR DISORDERS; CRANIOCEREBRAL TRAUMA; BRAIN NEOPLASMS; BRAIN HYPOXIA; INTRACRANIAL HEMORRHAGES; and infectious processes. Dejerine-Roussy Syndrome,Thalamic Syndrome,Dejerine Roussy Syndrome,Disease, Thalamic,Diseases, Thalamic,Syndrome, Dejerine-Roussy,Syndrome, Thalamic,Syndromes, Thalamic,Thalamic Disease,Thalamic Syndromes
D013787 Thalamic Nuclei Several groups of nuclei in the thalamus that serve as the major relay centers for sensory impulses in the brain. Nuclei, Thalamic

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