Interest of repetitive transcranial magnetic stimulation of the motor cortex in the management of refractory cancer pain in palliative care: Two case reports

Palliative Medicine
Julien NizardJ P Nguyen

Abstract

Non-drug treatments should be systematically associated to the medical analgesic treatment during the terminal phase of cancer. Patient 1, a 23-year-old woman, presented an adenocarcinoma of the rectum, with liver and lung metastases. Pain was initially treated by oral morphine and a combination of pregabalin and amitriptyline. Ketamine and intrathecal administration of morphine were both ineffective. Patient 2, a 69-year-old woman, presented a cutaneous T-cell lymphoma. She was admitted to the palliative care unit with mixed pain related to cutaneous lymphomatous infiltration. World Health Organization (WHO) step 3 analgesics had not been tolerated. Both patients received five consecutive 20-min sessions of repetitive transcranial magnetic stimulation to the right motor cortex. Patient 1 experienced a marked improvement of her pain over the days following the first repetitive transcranial magnetic stimulation session. Medical treatment was able to be rapidly decreased by about 50%, which restored an almost normal level of consciousness and lucidity. Patient 2's pain was also markedly decreased over the days following these five consecutive sessions, and repetitive transcranial magnetic stimulation also appeared to have had a b...Continue Reading

References

Sep 21, 2011·Nature Reviews. Neurology·Jean-Paul NguyenJean-Pascal Lefaucheur
Dec 14, 2011·Neurophysiologie clinique = Clinical neurophysiology·J-P LefaucheurL Garcia-Larrea
Mar 14, 2012·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Marco MaltoniOriana Nanni
Jun 8, 2012·Neurourology and Urodynamics·Jean-Marie LouppeJulien Nizard

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Citations

Jul 16, 2016·Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology·Jean-Paul NguyenJulien Nizard
Jul 12, 2017·F1000Research·Marcin Chwistek
May 11, 2020·Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology·Hasan HodajJean-Pascal Lefaucheur

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