Occipital nerve stimulation for pain modulation in drug-resistant chronic cluster headache
Entity
UAM. Departamento de MedicinaPublisher
MDPIDate
2021-02-13Citation
10.3390/brainsci11020236
Brain Sci. 11.2 (2021): 236
ISSN
2076-3425DOI
10.3390/brainsci11020236Funded by
Publication costs and financial support for medical writing were provided by Boston Scientific. The funder was not involved in the study design, collection, analysis, interpretation of data, the writing of this article or the decision to submit it for publicationEditor's Version
https://doi.org/10.3390/brainsci11020236Subjects
Chronic; Cluster headache; Drug-resistant; Neuromodulation; Occipital nerve stimulation; Refractory; MedicinaRights
© 2021 by the authorsAbstract
Occipital nerve stimulation (ONS) is a surgical treatment proposed for drug-resistant chronic cluster headache (drCCH). Long-term series assessing its efficacy are scarce. We designed a retrospective observational study with consecutive sampling, evaluating the follow-up of 17 drCCH patients who underwent ONS. Our main endpoint was the reduction the rate of attacks per week. We also evaluated the pain intensity through the Visual Analogue Scale (VAS), patient overall perceived improvement and decrease in oral medication intake. After a median follow-up of 6.0 years (4.5-9.0), patients decreased from a median of 30 weekly attacks to 22.5 (5.6-37.5, p = 0.012), 7.5 at 1 year (p = 0.006) and 15.0 at the end of follow-up (p = 0.041). The VAS decreased from a median of 10.0 to 8.0 (p = 0.011) at three months, to 7.0 (p = 0.008) at twelve months and 7.0 (p = 0.003) at the end of the follow-up. A total of 23.5% had an overall perceived improvement of ≥ 70% at 3 months, 41.2% at 1 year and 27.8% at the end of follow-up. Reducing prophylactic oral medication was possible in 76,5% and it was stopped in 17.7%. Triptan use decreased in all the responder patients and 17.7% stopped its intake. A total of 41.2% presented mild adverse events. In conclusion, our long-term experience suggests that ONS could be an interesting option for drCCH-selected patients, as it is a beneficial and minimally invasive procedure with no serious adverse events
Files in this item
Google Scholar:Díaz-de-Terán, Javier
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Membrilla, Javier A.
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Paz-Solís, José
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de Lorenzo, Iñigo
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Roa, Javier
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Lara-Lara, Manuel
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Gil-Martínez, Alfonso
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Díez Tejedor, Exuperio
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