{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T01:05:41Z","timestamp":1779843941918,"version":"3.53.1"},"reference-count":58,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"21","license":[{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2026,5,25]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Chronic migraine is a highly disabling neurological disorder. A subset of patients develop chronic daily headaches refractory to all standard therapies. MR-guided focused ultrasound (MRgFUS) ventral intermediate nucleus (VIM) thalamotomy is an incisionless treatment for medication-refractory essential tremor (ET).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 76-year-old woman with a 40-year history of chronic migraine with near-daily attacks, characterized predominantly by right-sided headaches and unresponsive to multiple preventive and acute treatments, underwent MRgFUS VIM thalamotomy for severe ET. After the procedure, her tremor resolved, and her chronic migraines were no longer reported during long-term follow-up. Shortly after the procedure, she developed burning mouth syndrome (BMS), characterized by bilateral oral burning dysesthesias with left-sided predominance involving the lips and oral mucosa. She was treated with gabapentin and amitriptyline, with partial symptomatic improvement. Postprocedure MRI confirmed the intended VIM lesion with slight medial extension toward the adjacent ventral posteromedial nucleus (VPM) of the thalamus, which relays trigeminal somatosensory input.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>This unique case illustrates that ablative neuromodulation of thalamic networks may be followed by marked improvement or remission of chronic refractory migraine, further supporting a possible role for the thalamus in migraine pathophysiology and pain transmission. It also highlights a potential trade-off: lesion extension toward nearby sensory nuclei, including the VPM, may be associated with focal central pain manifesting as BMS.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE251040\">https:\/\/thejns.org\/doi\/10.3171\/CASE251040<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case251040","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T14:52:30Z","timestamp":1779288750000},"source":"Crossref","is-referenced-by-count":0,"title":["Resolution of chronic refractory migraine and development of burning mouth syndrome after focused ultrasound thalamotomy: illustrative case"],"prefix":"10.3171","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3411-6266","authenticated-orcid":true,"given":"Shachar Zion","family":"Shemesh","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Sheba Medical Center, Ramat Gan"},{"name":"Gray Faculty of Medicine, Tel Aviv University, Tel Aviv"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2637-8517","authenticated-orcid":true,"given":"Paz","family":"Kelmer","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sheba Medical Center, Ramat Gan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3150-0641","authenticated-orcid":true,"given":"Tsvia","family":"Fay-Karmon","sequence":"additional","affiliation":[{"name":"Movement Disorders Institute, Department of Neurology, Sheba Medical Center, Ramat Gan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Hassin-Baer","sequence":"additional","affiliation":[{"name":"Gray Faculty of Medicine, Tel Aviv University, Tel Aviv"},{"name":"Movement Disorders Institute, Department of Neurology, Sheba Medical Center, Ramat Gan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lior","family":"Ungar","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sheba Medical Center, Ramat Gan"},{"name":"Dina Recanati School of Medicine, Reichman University, Herzliya, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"1","key":"bib1","series-title":"J Headache Pain","first-page":"17","article-title":"Migraine is first cause of disability in under 50s: will health politicians now take notice?","volume":"19","author":"Steiner","year":"2018","unstructured":"Steiner TJStovner LJVos TJensen RKatsarava Z.Migraine is first cause of disability in under 50s: will health politicians now take notice? 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