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Long-Term Outcomes of Occipital Nerve Stimulation for New Daily Persistent Headache With Migrainous Features

Lagrata, S; Cheema, S; Watkins, L; Matharu, M; (2020) Long-Term Outcomes of Occipital Nerve Stimulation for New Daily Persistent Headache With Migrainous Features. Neuromodulation:Technology at the Neural Interface 10.1111/ner.13282. Green open access

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Abstract

Objectives: New daily persistent headache (NDPH) is a subset of chronic headache where the pain is continuous from onset. Phenotypically it has chronic migraine or chronic tension type features. NDPH is considered to be highly refractory. Occipital nerve stimulation (ONS) has been used for treatment of refractory chronic migraine but there are no specific reports of its use for NDPH with migrainous features. / Materials and Methods: Nine patients with NDPH with migrainous features were identified as having had ONS implants between 2007 and 2014 in a specialist unit with experience of using ONS in chronic migraine. Moderate to severe headache days were compared at baseline and follow‐up. A positive response was defined as at least 30% reduction in monthly moderate to severe headache days. / Results: Patients had suffered NDPH for a median of 8 years (range 3–16 years) and had failed a median of 11 previous treatments (range 8–15). After a median follow‐up of 53 months (range 27–108 months), only a single patient showed a positive response to ONS. At no point did the cohort as a whole show any change in monthly moderate to severe headache days or disability scores. / Conclusion: Our experience suggests that ONS is not effective in the treatment of NDPH with migrainous features even in centers with experience in treating chronic migraine with ONS. The difference in response rates of chronic migraine and NDPH with migrainous features supports the concept of a different pathophysiology to the two conditions.

Type: Article
Title: Long-Term Outcomes of Occipital Nerve Stimulation for New Daily Persistent Headache With Migrainous Features
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/ner.13282
Publisher version: http://dx.doi.org/10.1111/ner.13282
Language: English
Additional information: © 2020 The Authors. Neuromodulation: Technology at the Neural Interface published by Wiley Periodicals LLC on behalf of International Neuromodulation Society. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
Keywords: Chronic headache, chronic migraine, new daily persistent headache, occipital nerve stimulation
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Brain Repair and Rehabilitation
URI: https://discovery.ucl.ac.uk/id/eprint/10112116
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