Stereotactic mesencephalotomy for pain relief. A plea for stereotactic surgery

K. Amano, H. Kawamura, T. Tanikawa, H. Kawabatake, Hiroshi Iseki, T. Taira

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Rostral mesencephalic reticulotomy (RMR) for pain relief was performed in 34 patients with intractable pain. Most of these patients have been followed for a long period of time postoperatively, the longest follow-up period being 11 years. Contrary to the commonly prevailed bias in the past that mesencephalotomy may be a surgical intervention with potential risk, these patients of RMR have continued to substantial improvement postoperatively in terms of their preoperative intractable painful dysesthesia after a long period of time. The results of pain relief for denervation pain as well as for nondenervation pain are surprisingly good even after unilateral procedures. There was no operative mortality. Postoperative disturbance of ocular motility has been reduced. RMR has its scientific basis in that the medial part of the reticular formation rather than the classical lateral spinothalamic tract has more significance in the central conduction of nociceptive impulses through the midbrain level, which was verified by intraoperative neuronal recording with a tungsten microelectrode. The present report emphasizes that stereotactic mesencephalotomy, if performed meticulously and precisely, is a safe surgical procedure for pain relief. Results of MRI and sensory manifestations of a patient 11 years after RMR are also presented.

Original languageEnglish
Pages (from-to)25-32
Number of pages8
JournalStereotactic and Functional Neurosurgery
Volume59
Issue number1-4
DOIs
Publication statusPublished - 1992
Externally publishedYes

Fingerprint

Pain
Spinothalamic Tracts
Intractable Pain
Tungsten
Reticular Formation
Paresthesia
Microelectrodes
Denervation
Mesencephalon
Mortality

Keywords

  • mesencephalotomy
  • midbrain
  • MRI
  • nociceptive neuron
  • pain
  • reticular formation
  • stereotactic surgery

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Amano, K., Kawamura, H., Tanikawa, T., Kawabatake, H., Iseki, H., & Taira, T. (1992). Stereotactic mesencephalotomy for pain relief. A plea for stereotactic surgery. Stereotactic and Functional Neurosurgery, 59(1-4), 25-32. https://doi.org/10.1159/000098913

Stereotactic mesencephalotomy for pain relief. A plea for stereotactic surgery. / Amano, K.; Kawamura, H.; Tanikawa, T.; Kawabatake, H.; Iseki, Hiroshi; Taira, T.

In: Stereotactic and Functional Neurosurgery, Vol. 59, No. 1-4, 1992, p. 25-32.

Research output: Contribution to journalArticle

Amano, K, Kawamura, H, Tanikawa, T, Kawabatake, H, Iseki, H & Taira, T 1992, 'Stereotactic mesencephalotomy for pain relief. A plea for stereotactic surgery', Stereotactic and Functional Neurosurgery, vol. 59, no. 1-4, pp. 25-32. https://doi.org/10.1159/000098913
Amano, K. ; Kawamura, H. ; Tanikawa, T. ; Kawabatake, H. ; Iseki, Hiroshi ; Taira, T. / Stereotactic mesencephalotomy for pain relief. A plea for stereotactic surgery. In: Stereotactic and Functional Neurosurgery. 1992 ; Vol. 59, No. 1-4. pp. 25-32.
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