Role of Thalamotomy in Treatment of Chronic Severe Pain

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Abstract
Bilateral thalamotomy may be effective when other neurosurgical procedures have failed to relieve chronic severe pain, such as pain secondary to advanced cancer. An illustrative case is described. Parafascicular electrodes are placed bilaterally even in cases of unilateral pain. In some cases it is unnecessary to add the destructive effect of radiofrequency current. Three clinical-anatomic syndromes representing the effects of surgically produced thalamic lesions are described. Each was reconstructed from examination of several similar cases in which a particular nuclear complex was the chief site of the lesions.