Neuropathic Pain

Neuropathic pain refers to pain caused by primary damage and dysfunction of the nervous system. It is a type of chronic and spontaneous pain, mostly caused by sciatica and postherpetic neuralgia (commonly known as “生蛇” in Hong Kong). 

In terms of treating neuropathic pain, drug therapy nowadays is relatively ineffective. Traditional analgesics such as paracetamol or some non-steroidal anti-inflammatory drugs are not effective in relieving pain caused by dysfunctions of the nervous system.

Some psychiatrists have suggested using some psychiatric drugs, such as tricyclic antidepressants (TCA) or antiepileptics in relieving neuropathic pain. Although in some cases, these drugs appeared to be more effective than traditional analgesics, these psychiatric drugs bring a lot of side effects at the same time.  Therefore, using psychiatric drugs to treat neuropathic pain is not widely adopted in the United States and Europe.

For neuropathic pain that cannot be relieved by drugs, TMS can be a possible option. TMS  is an effective and non-invasive technique to treat a variety of neurological diseases.

By combining TMS with 3D brain imaging, the navigation system can accurately identify the target areas of the motor cortex, which allows precise stimulation. TMS can play a significant analgesic effect This is helpful in relieving chronic neuropathic pain.

Reference

Haanpää, M. & Treede, R.D. (2010). Diagnosis and classification of neuropathic pain. Pain: Clinical Updates,18(7).

Lefaucheur, J.P. et al. (2014). Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS). Clin Neurophysiol, 125(11):2150-206.https://www.ncbi.nlm.nih.gov/pubmed/25034472

Nurmikko,T. et al.(2016). Motor Cortex Reorganization and Repetitive Transcranial Magnetic Stimulation for Pain-A Methodological Study. Neuromodulation,19(7):669-678.

Treede, R.D., Jensen, T.S., Campbell. J.N., Cruccu, G., Dostrovsky, J.O., Griffin, J.W., Hansson, P., Hughes, R.,Nurmikko, T.,& Serra J.(2008). Neuropathic pain: redefinition and a grading system for clinical and research purposes. Neurology,70,1630–5.

Other

Ahdab R, Lefaucheur JP 2nd International Symposium on Navigated Brain Stimulation in Neurosurgery Charité – Universitätsmedizin Berlin (Organizer) 2011 May; 34-36

Mylius V, Lefaucheur JP 3rd International Symposium on Navigated Brain Stimulation in Neurosurgery Charité – Universitätsmedizin Berlin (Organizer) 2012 May; 27-29

Nurmikko TJ, Sacco P  3rd International Symposium on Navigated Brain Stimulation in Neurosurgery Charité – Universitätsmedizin Berlin (Organizer) 2012 May; 23-26

Nurmikko TJ, Sacco P  5th International Symposium on Navigated Brain Stimulation in Neurosurgery Charité – Universitätsmedizin Berlin (Organizer) 2014 June; 32-36