University of Standford and Motor cortex stim
 

According to this page, the University of Stanford offers motor Cortex stim...Any thoughts,,,,Micheal??

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Debbie

Deb -

The link didn't show up in your post. Try again?

Mike

link
 

Dear Debbie -

Sorry for the delay in responding to your question. I'm still trying to run-down the issue of side effects.

Mike

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Thanks Mike- I am very interested in this!

Deb

Sorry for the delay. Bottom line: if you predominantly have uncontrollable CRPS - as opposed to pain from brachial plexus - MCS is the way to go, ESPECIALLY at a place like Stanford, where the neurosurgeons know what they are doing. (For folks who primarily have brachial plexus issues, another surgical procedure on nerve roots in the spine - called a DREZotomy - appears to be favored. (Authorities available upon request.)

While there have been occasional reports of seizure disorders, they appear to be rare. From what I can see, the big problem used to be the migration of electrodes over time, requiring a second surgery, a problem that appears to have been solved with the introduction of newer leads with mesh backings: it's not easy for those guys to travel much. Further, it's been necessary to replace leads when they have become encrusted due to a condition known as "epidural fibrosis," but as of 2009 it was anticipated that technical improvements could could resolve the issue. See, Motor cortex electrical stimulation applied to patients with complex regional pain syndrome, Velasco F, Carrillo-Ruiz JD, Castro G, Argüelles C, Velasco AL, Kassian A, Guevara U, Pain. 2009 Dec 15;147(1-3):91-8, Epub 2009 Sep 29, FULL ONLINE TEXT @ http://www.rsds.org/2/library/articl...uiz_Castro.pdf :

5.4. Undesirable events

As mentioned above, 3 of our patients presented undesirable events:

1. Electrode breakage has been a complication reported in all procedures that use electrical stimulation through implanted electrodes. Several recommendations have been made to minimize this possibility, such as fixing the connector cable and electrode junctions to the bone at the level of the mastoid, placing the electrode subcutaneously in a deeper layer, avoiding loops to reduce the possibility of skin erosions, etc. However, electrode
breakage secondary to a direct trauma over its subcutaneous trajectory during an assault seems unavoidable risk.

2. In regard to the epidural fibrosis presented in one case and the electrode migration presented in another case, these may be in part caused by the available hardware used for MCS. We are using a tetrapolar plate electrode designed for SCS, which is rigid, thick and has no space to place sutures to be fixed to the Dura. The design of a 12-contact-electrode for cortical
recording and stimulation, that would avoid a two surgical stage procedure, it could be more flexible to adapt to cortical convexity and have a rim to place sutures that will fix it to the Dura, is already under consideration in several companies that built neurostimulators.

That said, there are no lifetime guarantees on all of the the implants, so if years from now, it suddenly stops working (or doesn't work nearly as well) you may have to catch a flight to San Jose for 300,000 mile maintainence, or its equivalent.

I would do it in your place!

Mike