NEUROMODULATION – SPINAL CORD, PERIPHERAL NERVE AND BRAIN STIMULATION
Methods and sites The commonest site for stimulation for pain is the spinal cord. Stimulation can also be delivered to sites within the brain (such as the thalamus) or occasionally over the motor cortex of the brain. Stimulation can be used for control of conditions other than pain, such as spasticity, bladder control in multiple sclerosis (MS), peripheral vascular disease (PVD) and angina. There is increasing interest in peripheral nerve stimulation for pain – sacral nerve stimulation for incontinence is well evidenced and more recently occipital nerve stimulation is gaining acceptance for occipital neuralgia, cluster headache and even migraine. This growth reflects in part improvements in technology – hitherto, systems able to deliver peripheral nerve stimulation have been unreliable.