Neuropathic Pain. “Nervous Diseases” No. 1, 2024
Research article authored by neurologists from the V.S. Buzaev International Medical Centre published in a Russian medical journal “Nervous Diseases “. The research paper is dedicated to the first experience in the Russian Federation of treating neuropathic pain using bilateral thalamotomy with MRI-guided focused ultrasound (MRgFUS) at the V.S. Buzaev International Medical Centre. ®. Valuable clinical experience was detailed and formatted as a research article, receiving high praise from reviewers in the medical journal “Nervous Diseases”
Neuropathic Pain. Clinical Case
Neuropathic (or neurogenic) pain – a type of pain,
caused by dysfunction of certain structures of the nervous system
The main question that arises for the patient is whether it is possible to get rid of such pain? The difficulty in eliminating neuropathic pain lies in the ineffectiveness of medication in most cases. Analgesics provide a temporary effect, eventually causing other unwanted side effects In such situations, the possibility of directly affecting the brain structures involved in the development of neuropathic pain is considered.
Modern neurosurgery has two approaches:
- Neuromodulation (electrical or pharmacological stimulation of the “target area” using implanted devices)
- Local destruction (targeted destruction of areas of the nervous system responsible for the formation of pain sensations)
In the V.S. Buzaev International Medical Centre ® a 39-year-old patient N. presented with complaints of aching pain, burning sensation, and lack of sensitivity below the level of the nipples, absence of movement in the legs, and impaired pelvic organ function. Several years ago, he suffered from severe spinal cord inflammation, and life since then has become a real nightmare. The patient described his pain as so pronounced and intense that the use of strong medications, including narcotic analgesics, did not provide significant relief. Additionally, he noted the development of side effects due to high doses of these medications.
In 2017, a spinal cord stimulation electrode was implanted in the patient, but unfortunately, there were no changes in health status and quality of life.
Having studied the global experience in treating neuropathic pain, doctors at the V.S. Buzaev International Medical Centre ® decided to use MRI-guided focused ultrasound for pain relief – for the first time in Russia
A medical consultation was organized by a group of specialists from the V.S. Buzaev International Medical Centre to decide on the possibility of treating the patient, and on 14.07.2022, a non-invasive operation was performed—bilateral thalamotomy using the MRgFUS method, lasting 3 hours and 15 minutes. During the intervention, the patient was conscious, allowing for clinical effect monitoring directly during the operation. Postoperative monitoring on the second day revealed no complications, and the intensity of the pain significantly decreased!
Throughout the year, specialists at the Buzaev Clinic regularly monitored the patient’s condition and adjusted the treatment plan. The quality of life for patient N. significantly improved, pain decreased, and the need for regular use of painkillers almost completely disappeared, with narcotic drugs being completely discontinued.
Thus, the V.S. Buzaev International Medical Centre became the first center in the Russian Federation to apply thalamotomy using MRI-guided focused ultrasound (MRgFUS) in the treatment of neuropathic pain.
The advantages of MRI-guided focused ultrasound treatment are its non-invasive nature, no need for incisions, craniotomy, or anesthesia. There is no need for implants, and there are no cosmetic defects resulting from the procedure. Surrounding body tissues are not affected, which helps reduce the risk of serious complications.
In the V.S. Buzaev International Medical Centre, focused ultrasound ultrasound (MRgFUS, MRgFUS, Neuravive treatment) since 2020, it has been successfully used in the treatment of essential tremor, Parkinson’s disease, dystonias, for the dissection of small hypothalamic hamartomas, and the elimination of neuropathic pain
This clinical case demonstrates a significant breakthrough in the treatment of neuropathic pain.
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