Journal
CURRENT OPINION IN NEUROLOGY
Volume 22, Issue 3, Pages 262-268Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/WCO.0b013e32832ae61e
Keywords
chronic headache; deep-brain stimulation; greater occipital nerve; neurostimulation
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Funding
- German Resarch Foundation (DFG)
- Sandler Family Trust
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Purpose of review Conventional management options in medically intractable chronic-headache syndromes, such as chronic migraine, chronic cluster headache and hemicrania continua, are often limited. This review summarizes the current concepts, approaches and outcome data of invasive device-based neurostimulation approaches using occipital-nerve stimulation and deep-brain stimulation. Recent findings Recently, there has been considerable progress in neurostimulation approaches to medically intractable chronic-headache syndromes. Previous studies have analysed the safety and efficacy of suboccipital neurostimulation in drug-resistant chronic-headache syndromes such as in chronic migraine, chronic cluster headache and hemicrania continua. The studies suggest suboccipital neurostimulation can have an effect even decades after onset of headaches, thus representing a possible therapeutic option in patients that do not respond to any medication. Similarly, to date over 50 patients with cluster headaches underwent hypothalamic deep-brain stimulation. From these, an average of 50-70% did show a significant positive response. Summary These findings will help to further elucidate the clinical potential of neurostimulation in chronic headache.
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