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Motor Cortex Stimulation: Neural Circuits and Practical Approach on Electrode Implantation Technique

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Neuromodulation Techniques for Pain Treatment

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Abstract

Motor cortex stimulation (MCS) is a useful technique for the treatment of pain in severe neuropathic pain syndrome in the face of superior limbs. Most descriptions drive implantation of epidural electrodes for MCS under general anesthesia, using navigation merely based on anatomic landmarks or in combination with intraoperative sensory evoked potentials (SEPs) for functional localization. However, intraoperative SEP is not able to provide target refining when there is massive deafferentation pain syndromes (e.g., brachial plexus avulsion or amputation). In this chapter, the authors share their experience of a simple technique for refining the localization and intraoperative mapping of motor cortex by the implementation of transdural electrical stimulation of cerebral cortex. Also they review the anatomical pathways possibly related to analgesic effects during MCS.

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Authors and Affiliations

  1. Department of Neurology, School of Medicine, University of São Paulo, São Paulo, Brazil

    Erich Talamoni Fonoff, Kleber Carlos de Azevedo Junior & Eduardo Joaquim Lopes Alho

Authors
  1. Erich Talamoni Fonoff
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  2. Kleber Carlos de Azevedo Junior
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  3. Eduardo Joaquim Lopes Alho
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Editor information

Editors and Affiliations

  1. Department of Functional Neurosurgery, Hospital de Base and Brasília Pain Institute, Brasília, Brazil

    Tiago da Silva Freitas

  2. Department of Neurosurgery, University of Sao Paulo, São Paulo, Brazil

    Bernardo Assumpcao de Monaco

  3. Florida Pain, Coral Gables, FL, USA

    Stanley Golovac

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Talamoni Fonoff, E., de Azevedo Junior, K.C., Lopes Alho, E.J. (2022). Motor Cortex Stimulation: Neural Circuits and Practical Approach on Electrode Implantation Technique. In: Freitas, T.d.S., Assumpcao de Monaco, B., Golovac, S. (eds) Neuromodulation Techniques for Pain Treatment. Springer, Cham. https://doi.org/10.1007/978-3-030-84778-4_22

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  • DOI: https://doi.org/10.1007/978-3-030-84778-4_22

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-84777-7

  • Online ISBN: 978-3-030-84778-4

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