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Case 2 Treatment
Presented by: Dr. Kris Kumar, Neurosurgeon
Intraoperative trial stimulation in left posterior limb of internal capsule produced annoying sensation but no pain relief. Electrode removed.
Electrode placed in Left sensory nucleus of the thalalmus. Trial stimulation - good pain relief.
August 30, 2002
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| CT head in immediate post op period showing electrode in left sensory nucleus of thalamus. | |
Post op: good pain control for 3 weeks. Patient weaned off methadone. Duragesic patch cut down to 25mg (from 100)
September 29, 2002
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| CT head showing electrode in left sensory nucleus of thalamus. | |
Mid October 2002: Pain relief from stimulation started failing.
Benefit from readjustment of stimulation parameters lasted only one day.
November 2002: Back to higher doses of narcotics.
Question:
- Motor Cortex stimulation?
- Intrathecal drug delivery implant?
