Neuropathic pain is a type of pain that occurs due to pathological excitation of neurons in the peripheral or central nervous system responsible for responding to physical damage to the body. Brain cells that respond to pain become excited without actual pain and send false pain signals. This pain occurs without physical damage.
Neuropathic pain may be associated with abnormal sensations (dysesthesia) or pain caused by stimuli that normally do not cause pain (allodynia). It can be constant or episodic. It may be piercing or similar to electric shocks. Common qualities include burning or cold, tingling and pricking sensations, numbness, and itching. The cause of neuropathic pain can be pathological processes in the peripheral and central nervous system. Thus, peripheral neuropathy, central and mixed genesis neuropathic pain are distinguished.
Neuropathic pain affects 7–8% of the European population, and in 5% of people, it can be severe.
This type of pain syndrome can be difficult to treat, and pain relief is not always fully achievable. Patients often experience sleep disturbances, depression, anxiety, and a reduced quality of life. Many suffer for a long time before receiving adequate help. Most patients (about 80%) experience pain for more than a year before their first visit to a specialist. Treatment of the underlying disease (which is naturally essential) does not always lead to pain reduction. We often observe a dissociation between the severity of pain and the degree of nervous system damage. Unfortunately, many patients with neuropathic pain mistakenly take NSAIDs, which are ineffective for this type of pain. This is because the main pathogenetic mechanisms in neuropathic pain are not the activation processes of peripheral nociceptors, but neuronal and receptor disorders, peripheral and central sensitization.
In the treatment of neuropathic pain, it is best to use a comprehensive approach.
Among the many treatment methods available in medicine today, one of the unique and modern treatment methods is MRI-guided focused ultrasound.
14.07.2022 Performed bilateral non-invasive
thalamotomy using MRgFUS,
lesion in the projection of C Lp thalamic nuclei on the left 4*5 mm To the right 4*7 мм.
There are no complications or side effects in the treatment.
The duration of therapy was 3 hours and 15 minutes.
Observing the patient since 24.06.2022
— pain reduction
(Questionnaire Pain Detect)
from 13 to 4-5 points
Pain Diary:
During the first month after the surgery, the average intensity of the pain syndrome during
The score was 5.9 points according to VAS, taking Tramadol 4 times.
For the second month after the surgery, the average intensity of the pain syndrome during the day
was 6.3 points on VAS, Tramadol was used 3 times.
During the third month after the surgery, the average intensity of the pain syndrome
scored 6.7 points on the VAS, increased need for tramadol – the patient used it 8 times
Venlafaxine was added to the treatment for pain syndrome correction in the patient after surgery
which the patient took at a dosage of 75 mg/day for 3 months
Refused to increase the dosage of the medication, as it was associated with weight gain, drowsiness, and lethargy
sluggishness during the day
The patient was consulted by a psychotherapist clinics due to a pronounced psycho-emotional component
in relation to the pain syndrome, cognitive-behavioral pain therapy was recommended
On an MRI of the brain, using special protocols, we visualize the focus of pain excitation, the point that is a constant source of pain. The MRgFUS platform helmet focuses up to a thousand ultrasound beams on this focus, with an accuracy within 1 millimeter. The focused ultrasound heats the neurons in the focus. At certain, low energy levels of exposure, the neurons “fall asleep,” allowing the neurosurgeon and neurologist to assess whether the target area was correctly chosen. The neurologist evaluates the presence of pain, its localization and intensity; absence of side effects, overall neurological status. If the pain persists or other neurological symptoms appear, a new “target” point is sought, and the neurons at the previous heating point cool down and return to normal functioning without any damage or disruption of functions.
If the pain disappears or significantly decreases, and doctors do not observe the appearance of unwanted neurological symptoms, the heating of the focus is repeated, but with the use of higher energies. This leads to the reliable elimination of the pain focus and stops neuropathic pain.
This type of treatment is performed on an outpatient basis, without pain, without surgery, and without incisions!
This procedure, as part of the therapy, provides relief and absence of pain that you have been seeking for many years.
The method has specific indications and contraindications. You should consult a specialist about the possibility of use in each specific case.
Authors of the text: Yulia Viktorovna Yudina, Alexey Borisovich Saveliev.