Research on thalamic central pain

[Joe B]

This is anabstarct from Medline that describes one situation in which central pain was stopped in a thalamic patient.

Department of Neurology, Medical University of Lubeck, Ratzeburger Allee 160, D-23538, Lubeck, Germany

At present there is hardly any appropriate therapy for central pain syndromes available. We report on a unique case of a central thalamic pain syndrome that did not respond to any therapy but disappeared after an additional contralateral parietal lobe lesion. This example indicates that lesions affecting the bilateral balance of thalamo-parietal circuits may lead to pain relief in patients with central pain syndrome, which probably constitutes a bilateral disorder of functional plasticity. This should be taken into account in chronic brain stimulation for persistent pain states.

Joe B
C6-7
1988

[David Berg]

The parietal lobe is receiving some attention lately, but I'm highly skeptical of any ablative (destructive) surgery for pain management. Way too often, I've heard of people having the surgery, feeling great for awhile, only to have the pain return within a year or two, perhaps worse than before.

David Berg

[Joe B]

David

I agree with you that inducing a lesion surgically in hopes of relief is undesirable.

I believe the authors were proposing some form of stimulation of the parietal lobe rather than lesion.

I didn't know that this had been tried in humans. You said that in some cases pain relief was achieved but returned after a couple of years. That at least seems to indicate the parietal lobe is a promising avenue for study.

Thanks for that information.

As an observation, now that central or thalamic pain is a recognized problem, I see a lot of people confusing it with chronic pain. I have seen some posts where Drs have prescribed Neurontin to treat what seems to me to be chronic pain and the patient state they get no relief. Neurontin right now is a lot of Drs favorite to prescribe for pain whose cause is not readily apparent. Sort of wont hurt, might help basis.

Joe B
C6-7
1988

[David Berg]

Originally posted by Joe B:

I have seen some posts where Drs have prescribed Neurontin to treat what seems to me to be chronic pain and the patient state they get no relief. Neurontin right now is a lot of Drs favorite to prescribe for pain whose cause is not readily apparent. Sort of wont hurt, might help basis.

As far as I'm concerned, doctors who prescribe Neurontin for non-neuropathic pain are ignorant, irresponsible, or just lazy. I prefer to view them as ignorant. Either they don't understand the role Neurontin in pain management or they don't know how to effectively recognize neuropathic pain when they see it.

Neurontin is a powerful drug with some powerful possible adverse effects. I have one case in my records of an individual who apparently has central pain as a consequence of taking Neurontin for something else and sure enough, if you read the drug info it includes possible (but rare) side effects that include symptoms such as dysesthesia (burning nerve pain). Be aware of the possible side effects before taking any drug. Too often the doctors aren't familiar enough with the range of possibilities.

The vast majority of the time, Neurontin is a valuable tool that might help people suffering from nerve pain. The trick is to be an informed consumer and use it wisely.

David Berg