Stereotaxic Midbrain Lesions for Central Dysesthesia and Phantom Pain

T was shown 25 years ago by Walker that sectioning of the lateral spinothalamic and quintothalamic tracts in the mesencephalon at the level of the superior calliculus resulted in analgesia and thermanesthesia over the opposite half of the body21 The open operation did not gain wide acceptance because of the occurrence of severe postoperative dysesthesias. In 1948, Spiegel and Wycis developed a stereotaxic approach coagulating the lateral tegmentum at the level of the posterior commissure. ~3 Recent reports of significant relief of pain by this method of treatment prompted our own study of the problem. 3,7,16,~1,~,~.8 The present report concerns the attempts to relieve phantom arm pain and central pain in a group of 15 patients.