Continuous electrical stimulation of bilateral occipital nerve was found to be effective in the treatment of interactable cluster headahe.Eight patients with medically intractable chronic cluster headache were implanted in the suboccipital region with electrodes for occipital nerve stimulation.At a median follow-up of 20 months ( for bilateral stimulation), six of eight patients reported responses that were sufficiently meaningful for them to recommend the treatment to similarly affected patients with chronic cluster headache. Two patients noticed a substantial improvement (90% and 95%) in their attacks; three patients noticed a moderate improvement (40%, 60%, and 20–80%) and one reported mild improvement (25%). Improvements occurred in both frequency and severity of attacks. These changes took place over weeks or months, although attacks returned in days when the device malfunctioned (eg, with battery depletion). Adverse events of concern were lead migrations in one patient and battery depletion requiring replacement in four.In these patients a range of different stimulation frequencies, pulse widths, and voltages were used.Peripheral nerve stimulation has been used in neuropathic pain with mixed success in the past.
Source.Lancet
Wednesday, April 18, 2007
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