Neurophysiological monitoring in the treatment of pain.

Fernández-González F, Seijo F, Valles C, Fernández-Alonso R.
Servicio de Neurofisiología Clínica, Hospital Central de Asturias, Oviedo, España.

The concept of transynaptic deafferentation secondary to a lesion is the basis of the therapeutic criteria of functional neurosurgery.

Pain due to deafferentation requires clinical neurophysiological techniques for characterization, and when appropriate, for localization of the level of the lesion and the ectopic focus or foci which cause the pain syndrome.
However, monitoring therapeutic interventions in the pain clinic is an ever increasing need, and obliges the clinical neurophysiologist to master the range of techniques involved in his specialty, so that he can use the most suitable techniques and methods as required by each condition and/or case.
The use of techniques such as micro-recordings of the unitary or multiunitary activity of the nerves or nuclei, intracerebral evoked potentials, nociceptive evoked potentials, reflexology, polysomnography and topography, together with techniques such as percutaneous objective localization of deep nerves, allows quantitative evaluation pre-, intra- and postoperative.

The development of neuromodulation, and in particular of acute or long-term neurostimulation by use of percutaneous techniques, offers an effective therapeutic option in the field of clinical neurophysiology.

Revista de neurologia, 2000 Mar 16-31;30(6):567-76.

Key-words: Reflexology, Neurostimulation, Neuromodulation, pain, percutaneous techniques.