Effect of Repetitive Transcranial Magnetic Stimulation in Patients with Intractable Neuropathic Pain: Cases report

ABSTRACT

Drug resistant neuropathic pain can be relieved by non-invasive new therapy of repetitive transcranial magnetic stimulation (rTMS). Three patients who have been suffered from intractable neuropathic pain with diverse underlying causes were enrolled. The causes of their pain were the thalamic hemorrhage, the complex regional pain syndrome (CRPS) after resection of neurilemmoma, and the trigeminal schwanoma respectively. A thousand pulses of 10 Hz rTMS were delivered over the contralateral primary motor cortex at 80% of resting motor threshold for a period of 20 minutes per each treatment session. The intensity of pain was assessed using a visual analogue scale before and after rTMS session for 5 consecutive days. Immediate and dramatic analgesic effects were noticed as a result of rTMS in patients with thalamic hemorrhage and trigerminal schwanoma. Moderate analgesic effect was noticed in patient with CRPS. The duration of analgesic effect was variable.