Miller, S;
Lagrata, S;
Watkins, L;
Matharu, M;
(2017)
Occipital Nerve Stimulation for Medically Refractory Chronic Paroxysmal Hemicrania.
Headache
, 57
(10)
pp. 1610-1613.
10.1111/head.13187.
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Abstract
OBJECTIVE: To describe the outcome of a patient with refractory chronic paroxysmal hemicrania (CPH) to occipital nerve stimulation (ONS). BACKGROUND: CPH is a primary headache disorder exquisitely sensitive to indomethacin. In patients unable to tolerate indomethacin, the therapeutic options are limited. ONS is a promising therapy for other refractory headache conditions. We report the first patient with medically refractory CPH treated with ONS. METHODS: Following implantation of the occipital nerve stimulator in 2006, the patient kept prospective headache diaries. Outcome was assessed by daily attack frequency. RESULTS: After a follow-up of over 10 years, the patient reported a sustained efficacy of more than 50% reduction in attack frequency and was pain-free at final follow-up. The patient was able to stop indomethacin completely. The patient had three successful pregnancies during follow-up. One system revision was undertaken alongside an expected battery replacement to treat unequal paresthesia and pain over the electrodes. CONCLUSION: ONS may offer an effective long-term treatment for CPH in patients where indomethacin cannot be tolerated.
| Type: | Article |
|---|---|
| Title: | Occipital Nerve Stimulation for Medically Refractory Chronic Paroxysmal Hemicrania |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1111/head.13187 |
| Publisher version: | http://doi.org/10.1111/head.13187 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | indomethacin sensitive headache, intractable headache, neurostimulation, occipital nerve stimulation, paroxysmal hemicrania, pregnancy, trigeminal autonomic cephalalgia |
| 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/1559208 |
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