Motor Cortex Stimulation (MCS) is a neurosurgical procedure that involves placing of an electrode on the surface of the brain to control pain signals. It is an off-label procedure, which means it is not yet FDA-approved worldwide. Surgery is performed in one stage which means that on the day of the surgery both the electrode and the pulse generator (IPG) is implanted. The surgery is performed under general anaesthesia, neuronavigation and previously performed data derived from the functional MRI are used to pinpoint the precise area to target the desired location. During surgery neurophysiologic monitoring techniques like somatosensory evoked potentials and motor evoked potentials are used to gather extra information in order to establish the area of target.
Patients considering motor cortex stimulation should have realistic expectations for results. The surgery relieves symptoms, but it is not a cure. It can also take up to a minimum of three months of adjustments and programming of the IPG after surgery to achieve optimal results. We started our MCS programm in 2005, in our experience about 50 to 60 percent of our patients experience significant pain relief from motor cortex stimulation. Therefore careful selection of patients is required.