Motor Cortex Stimulation
Surgical Treatments for Facial Neuralgias

Disclaimer.

Developed in Japan in the 1980’s, Motor Cortex Stimulation (MCS) has been used to treat epilepsy and movement disorders such as Parkinson’s Disease.  Lately, it is being used to treat people with facial or neck pain for whom standard treatments have not worked. This procedure is usually only employed when other treatments have failed, for it involves brain surgery with  all its risks, including infection and surgical complications.

In a nutshell, Motor Cortex Stimulation uses a programmable device to send electric pulses to an electrode attached to the layer covering the brain, and helps reduce chronic, intractable neuropathic pain for some people.

Two separate surgeries under general anesthesia are performed. First, brain imaging is used to map the brain and identify the motor cortex, the part of the brain associated with movement of the face, neck, arms and legs.

In the first surgery, an electrode is surgically placed on the tough protective layer covering the motor cortex area of the brain and then hooked up to a programmable device. Once the patient is awake after surgery, electronic pulses from the device are adjusted to stimulate the brain in such a way as to reduce pain.  Once the pain is consistently reduced by at least 50%, a second surgery is done to more permanently connect the electrode and to insert the programmable device under the skin, often near the collarbone.  A connecting wire from the device goes up the back of the neck and under the scalp to the electrode.

Pros and Cons
Motor Cortex Stimulation is not a perfect solution for chronic pain. As with most  treatments, some patients get no pain relief.  As yet, there are no studies that show this procedure provides long-term pain relief. In addition, the stimulation device has only been approved by the FDA to treat movement disorders and spinal pain conditions.

However, this procedure has provided amazing pain relief to some people in terrible pain for whom no other treatment has worked.

More Information
Motor Cortex Stimulation.  By TNA Medical Advisory Board member Jeffrey A. Brown, MD, and Julie G. Pilitsis, MD, PhD. 

Personal Experiences
To get a patient’s perspective on Motor Cortex Stimulation, read Bridget Kelly’s “Motor Cortex Stimulation: A Patient's Perspective and Guide to Surgery,” a paper she presented at the Trigeminal Neuralgia Association 2004 National Conference. In it, she gives a detailed description of her experiences with MCS along with information about clinics and physicians specializing in this procedure and an extensive bibliography.

If you are considering Motor Cortex Stimulation,  contact the Trigeminal Neuralgia Association to get the latest information about it.