Deep Brain Stimulation in Pain Syndromes

© 2013 by John Wiley & Sons, Ltd. All rights reserved. Although deep brain stimulation (DBS) has become well known as an important therapy for treating movement disorders such as Parkinson's disease (PD), tremor, and dystonia, it was in fact used for chronic pain over 50 years ago by stimulating the hypothalamus. Patients with chronic neuropathic pain are often complex and pain can be very difficult to assess objectively. Patients that are suitable for DBS are ones that have pain refractory to multiple medication regimes and multiple classes of analgesics. Patients should be aware that having a DBS implant will require fairly regular follow‐up for programming and battery changes every few years. They should also be aware that DBS rarely removes the pain completely and the intention is to significantly reduce the intensity of the pain. Stimulation related side‐effects can generally be mitigated by adjustment of the stimulation parameters.