Deep brain stimulation in headache

被引:34
作者
Leone, Massimo [1 ,2 ]
Cecchini, Alberto Proietti
机构
[1] Fdn Ist Nazl Neurol Carlo Besta, Dept Neurol, Headache & Neurol Dept, Via Celoria 11, I-20133 Milan, Italy
[2] Fdn Ist Nazl Neurol Carlo Besta, Pain Neuromodulat Unit, Via Celoria 11, I-20133 Milan, Italy
关键词
Deep brain stimulation; hypothalamic stimulation; neurostimulation; intractable; drug resistant; cluster headache; paroxysmal hemicrania; SUNCT; trigeminal autonomic cephalalgias; trigeminal neuralgia; CHRONIC CLUSTER HEADACHE; UNILATERAL NEURALGIFORM HEADACHE; POSTERIOR HYPOTHALAMIC AREA; CONJUNCTIVAL INJECTION; EFFICACY; NEUROMODULATION; EXPERIENCE; SECONDARY; REGION;
D O I
10.1177/0333102415607176
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: Deep brain stimulation of the posterior hypothalamic area was first introduced in 2000 to treat drug-refractory chronic cluster headache (CH). Findings: So far, hypothalamic stimulation has been employed in 79 patients suffering from various forms of intractable short-lasting unilateral headache forms, mainly trigeminal autonomic cephalalgias. The majority were (88.6%) chronic CH, including one patient who suffered from symptomatic chronic CH-like attacks; the remaining were short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT), one had paroxysmal hemicranias and one symptomatic trigeminal neuralgia. Overall, after a mean follow up of 2.2 years, 69.6% (55) hypothalamic-stimulated patients showed a 50% improvement. Conclusions: These observations need confirmation in randomised, controlled trials. A key role of the posterior hypothalamic area in the pathophysiology of unilateral short-lasting headaches, possibly by regulating the duration rather than triggering the attacks, can be hypothesised. Because of its invasiveness, hypothalamic stimulation can be proposed only after other, less-invasive, neurostimulation procedures have been tried.
引用
收藏
页码:1143 / 1148
页数:6
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