Long-term motor cortex stimulation for phantom limb pain

Abstract

We present the long-term course of motor cortex stimulation to relieve a case of severe burning phantom arm pain after brachial plexus injury and amputation. During 16-year follow-up the device continued to provide efficacious analgesia. However, several adjustments of stimulation parameters were required, as were multiple pulse generator changes, antibiotics for infection and one electrode revision due to lead migration. Steady increases in stimulation parameters over time were required. One of the longest follow-ups of motor cortex stimulation is described; the case illustrates challenges and pitfalls in neuromodulation for chronic pain, demonstrating strategies for maintaining analgesia and overcoming tolerance.

Keywords::

• long-term outcome
• motor cortex stimulation
• neuromodulation
• phantom limb pain

Acknowledgments

The authors alone managed the patient clinically and wrote the manuscript. They have no conflicts of interest.

Declaration of interest: The authors report no declarations of interest. The authors alone are responsible for the content and writing of the paper.