scholarly journals Long‐Term Outcomes of Occipital Nerve Stimulation for New Daily Persistent Headache With Migrainous Features

2020 ◽  
Author(s):  
Susie Lagrata ◽  
Sanjay Cheema ◽  
Laurence Watkins ◽  
Manjit Matharu
Keyword(s):  
Nerve Stimulation ◽  
Occipital Nerve Stimulation ◽  
Long Term Outcomes ◽  
New Daily Persistent Headache ◽  
Occipital Nerve ◽  
Persistent Headache

scholarly journals Long-term outcomes of occipital nerve stimulation for chronic migraine: a cohort of 53 patients

2016 ◽  
Vol 17 (1) ◽  
Author(s):  
Sarah Miller ◽  
Laurence Watkins ◽  
Manjit Matharu
Keyword(s):  
Chronic Migraine ◽  
Nerve Stimulation ◽  
Occipital Nerve Stimulation ◽  
Long Term Outcomes ◽  
Occipital Nerve

185 Long-term Follow-up in Functional Outcomes of Combined Supraorbital Nerve Stimulation and Occipital Nerve Stimulation for Chronic Headache Patients

Neurosurgery ◽  
2015 ◽  
Vol 62 ◽  
pp. 227-228
Author(s):  
Shannon Wang Clark ◽  
Chengyuan Wu ◽  
David Boorman ◽  
Nohra Chalouhi ◽  
Mario Zanaty ◽  
...  
Keyword(s):  
Nerve Stimulation ◽  
Functional Outcomes ◽  
Chronic Headache ◽  
Occipital Nerve Stimulation ◽  
Occipital Nerve ◽  
Supraorbital Nerve ◽  
Long Term Follow Up ◽  
Headache Patients

scholarly journals Occipital Nerve Stimulation for Refractory Chronic Migraine: Results of a Long-Term Prospective Study

2017 ◽  
Vol 1 (21;1) ◽  
pp. E151-E159 ◽  
Author(s):  
Dolores Rodrigo
Keyword(s):  
Surgical Technique ◽  
Chronic Migraine ◽  
Nerve Stimulation ◽  
Occipital Nerve Stimulation ◽  
Open Label ◽  
Occipital Nerve ◽  
Refractory Chronic Migraine

Background: Refractory chronic migraine affects approximately 4% of the population worldwide and results in severe pain, lifestyle limitations, and decreased quality of life. Occipital nerve stimulation (ONS) refers to the electric stimulation of the distal branches of greater and lesser occipital nerves; the surgical technique has previously been described and has demonstrated efficacy in the treatment of a wide variety of headache disorders. Objectives: The aim of this study is to evaluate the long-term efficacy and tolerability of ONS for medically intractable chronic migraine. Study Design: Prospective, long-term, open-label, uncontrolled observational study. Setting: Single public university hospital. Methods: Patients who met the International Headache Society criteria for chronic migraine, all of them having been previously treated with other therapeutic alternatives, and who met all inclusion and exclusion criteria for neurostimulation, received the implantation of an ONS system after a positive psychological evaluation and a positive response to a preliminary occipital nerve blockage. The implantation was performed in 2 phases: a 10 day trial with implanted occipital leads connected to an external stimulator and, if more than 50% pain relief was obtained, permanent pulse generator implantation and connection to the previously implanted leads. After the surgery, the patients were thoroughly evaluated annually using different scales: pain Visual Analogue Scale (VAS), number of migraine attacks per month, sleep quality, functionality in social and labor activities, reduction in pain medication, patient satisfaction, tolerability, and reasons for termination. The average follow-up time was 9.4 ± 6.1 years, and 31 patients completed a 7-year follow-up period. Results: Thirty-seven patients were enrolled and classified according to the location and quality of their pain, accompanying symptoms, work status, and psychological effects. Substantial pain reduction was obtained in most patients, and the VAS decreased by 4.9 ± 2.0 points. These results remained stable over the followup period. Five of the 35 permanently implanted patients with migraine attacks at baseline were free from these attacks at their last visits, whereas the pain severity decreased 3.8 ± 2.5 (according to the VAS) in the remaining patients. Seven of the 35 permanent implanted devices were definitively removed: 2 devices because of treatment inefficacy, and 5 devices because the patients were asymptomatic and considered to be cured from their pain, even with the stimulation off. Systemic side effects were not observed. Limitations: Limitations of the current study include its uncontrolled and open-label design. Additionally, not all patients completed the 7-year follow-up period. Conclusions: We consider that the trigemino-cervical autonomous and cervical connection may explain why ONS might relieve chronic migraine pain, but this is just a theoretical explanation which should be demonstrated in future studies. The results achieved in this study suggest that ONS may provide longterm benefits for patients with medically intractable chronic migraine. These outcomes are slightly better than previous reports and were maintained over the 7-year follow-up. We believe that an accurate selection of patients, realization of diagnostic occipital nerve blocks, psychological evaluations, rigorous surgical technique, and appropriate parameter programming helped us achieve these outcomes. Key words: Refractory chronic migraine, headache, occipital nerve stimulatino, peripheral nerve stimulation, occipital nerve block

Treatment of medically intractable cluster headache by occipital nerve stimulation: long-term follow-up of eight patients

The Lancet ◽  
2007 ◽  
Vol 369 (9567) ◽  
pp. 1099-1106 ◽  
Author(s):  
Brian Burns ◽  
Laurence Watkins ◽  
Peter J Goadsby
Keyword(s):  
Cluster Headache ◽  
Nerve Stimulation ◽  
Occipital Nerve Stimulation ◽  
Occipital Nerve ◽  
Long Term Follow Up

Long-term occipital nerve stimulation for drug-resistant chronic cluster headache

Cephalalgia ◽  
2016 ◽  
Vol 37 (8) ◽  
pp. 756-763 ◽  
Author(s):  
Massimo Leone ◽  
Alberto Proietti Cecchini ◽  
Giuseppe Messina ◽  
Angelo Franzini
Keyword(s):  
Cluster Headache ◽  
Nerve Stimulation ◽  
Stable Condition ◽  
Chronic Cluster Headache ◽  
Drug Resistant ◽  
Occipital Nerve Stimulation ◽  
Occipital Nerve ◽  
Headache Patients

Introduction Chronic cluster headache is rare and some of these patients become drug-resistant. Occipital nerve stimulation has been successfully employed in open studies to treat chronic drug-resistant cluster headache. Data from large group of occipital nerve stimulation-treated chronic cluster headache patients with long duration follow-up are advantageous. Patients and methods Efficacy of occipital nerve stimulation has been evaluated in an experimental monocentric open-label study including 35 chronic drug-resistant cluster headache patients (mean age 42 years; 30 men; mean illness duration: 6.7 years). The primary end-point was a reduction in number of daily attacks. Results After a median follow-up of 6.1 years (range 1.6–10.7), 20 (66.7%) patients were responders (≥50% reduction in headache number per day): 12 (40%) responders showed a stable condition characterized by sporadic attacks, five responders had a 60–80% reduction in headache number per day and in the remaining three responders chronic cluster headache was transformed in episodic cluster headache. Ten (33.3%) patients were non-responders; half of these have been responders for a long period (mean 14.6 months; range 2–48 months). Battery depletion (21 patients 70%) and electrode migration (six patients – 20%) were the most frequent adverse events. Conclusions Occipital nerve stimulation efficacy is confirmed in chronic drug-resistant cluster headaches even after an exceptional long-term follow-up. Tolerance can occur years after improvement.

Long-Term Efficacy of Occipital Nerve Stimulation for Medically Intractable Cluster Headache

Neurosurgery ◽  
2020 ◽  
Author(s):  
Aurélie Leplus ◽  
Denys Fontaine ◽  
Anne Donnet ◽  
Jean Regis ◽  
Christian Lucas ◽  
...  
Keyword(s):  
Cluster Headache ◽  
Nerve Stimulation ◽  
Occipital Nerve Stimulation ◽  
Attack Frequency ◽  
Occipital Nerve ◽  
Term Efficacy ◽  
Additional Surgery ◽  
Over Time

ABSTRACT BACKGROUND Occipital nerve stimulation (ONS) has been proposed to treat refractory chronic cluster headache (rCCH) but its efficacy has only been showed in small short-term series. OBJECTIVE To evaluate ONS long-term efficacy in rCCH. METHODS We studied 105 patients with rCCH, treated by ONS within a multicenter ONS prospective registry. Efficacy was evaluated by frequency, intensity of pain attacks, quality of life (QoL) EuroQol 5 dimensions (EQ5D), functional (Headache Impact Test-6, Migraine Disability Assessment) and emotional (Hospital Anxiety Depression Scale [HAD]) impacts, and medication consumption. RESULTS At last follow-up (mean 43.8 mo), attack frequency was reduced >50% in 69% of the patients. Mean weekly attack frequency decreased from 22.5 at baseline to 9.9 (P < .001) after ONS. Preventive and abortive medications were significantly decreased. Functional impact, anxiety, and QoL significantly improved after ONS. In excellent responders (59% of the patients), attack frequency decreased by 80% and QoL (EQ5D visual analog scale) dramatically improved from 37.8/100 to 73.2/100. When comparing baseline and 1-yr and last follow-up outcomes, efficacy was sustained over time. In multivariable analysis, low preoperative HAD-depression score was correlated to a higher risk of ONS failure. During the follow-up, 67 patients experienced at least one complication, 29 requiring an additional surgery: infection (6%), lead migration (12%) or fracture (4.5%), hardware dysfunction (8.2%), and local pain (20%). CONCLUSION Our results showed that long-term efficacy of ONS in CCH was maintained over time. In responders, ONS induced a major reduction of functional and emotional headache-related impacts and a dramatic improvement of QoL. These results obtained in real-life conditions support its use and dissemination in rCCH patients.

Long-Term Pain Reduction Does Not Imply Improved Functional Outcome in Patients Treated With Combined Supraorbital and Occipital Nerve Stimulation for Chronic Migraine

2016 ◽  
Vol 19 (5) ◽  
pp. 507-514 ◽  
Author(s):  
Shannon W. Clark ◽  
Chengyuan Wu ◽  
David W. Boorman ◽  
Nohra Chalouhi ◽  
Mario Zanaty ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Chronic Migraine ◽  
Nerve Stimulation ◽  
Pain Reduction ◽  
Occipital Nerve Stimulation ◽  
Occipital Nerve
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