Motor cortex stimulation for refractory demyelinating disease-associated trigeminal neuralgia

Marcelo D Mendonça, Alexandra Seromenho-Santos, André Caetano, Carla Reizinho

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Patients with demyelinating diseases (DDs) such as multiple sclerosis have a 20-fold higher risk of developing trigeminal neuralgia (TN). DD-related TN is more frequently refractory to the usual medical and surgical treatment. We report the case of a 57-year-old man presenting to our neurology outpatient clinic with a 12-year history of medical and surgical refractory TN associated with demyelinating lesions on magnetic resonance imaging. After a new failure of pharmacological treatment with oxcarbazepine, pregabalin, baclofen, and duloxetine, motor cortex stimulation (MCS) was performed, and the patient remained mostly pain-free, without any pharmacological treatment during the 3.5 years of follow-up. MCS may be a useful approach for DD-related refractory TN, and further studies can clarify its role in TN management.
Original languageEnglish
Article number2515816319866149
JournalCephalalgia Reports
Publication statusPublished - 30 Jul 2019


  • motor cortex stimulation
  • pain
  • refractory
  • trigeminal neuralgia


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