scholarly journals Sphenopalatine (pterygopalatine) ganglion stimulation and cluster headache: New hope for ye who enter here

Cephalalgia ◽  
2013 ◽  
Vol 33 (10) ◽  
pp. 813-815 ◽  
Author(s):  
Peter J Goadsby
Cephalalgia ◽  
2011 ◽  
Vol 31 (11) ◽  
pp. 1236-1239 ◽  
Author(s):  
KPQ Oomen ◽  
AJM van Wijck ◽  
GJ Hordijk ◽  
JA de Ru

Background: Cluster headache is an invalidating form of headache. Although cluster headache can be managed pharmacologically, some patients require surgical treatment with varying results. Microvascular decompression of the pterygopalatine ganglion could be an alternative to traditional surgical management in patients with cluster headache. Methods: Microvascular decompression of the pterygopalatine ganglion was performed in three patients with refractory cluster headache. The pterygopalatine artery was ligated and a temporal muscle graft was placed between the artery and the ganglion. Results: No differences were found between the presurgical period and 1 week, 1 month, 3 months, and 6 months postoperatively with respect to attack duration and frequency, visual analogue scale score during attacks and in remission periods, duration of remissions, and quality of life. Conclusion: These preliminary data suggest that microvascular decompression of the pterygopalatine ganglion does not provide pain reduction or improvement of quality of life in patients with refractory cluster headache.


BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e026608 ◽  
Author(s):  
Jin Li ◽  
Hao Ren ◽  
Baoguo Wang ◽  
Dasheng Wu ◽  
Fang Luo

IntroductionSingle-centre reports on small groups of patients have shown that pterygopalatine ganglion pulsed radiofrequency treatment in patients with refractory cluster headache (CH) can quickly relieve pain without significant side effects. However, a randomised controlled trial is still necessary to evaluate whether pterygopalatine ganglion pulsed radiofrequency (PRF) treatment is a viable treatment option for patients with CH who are not responding to drug treatment.Methods and analysisThis investigation is a multicentre, prospective, randomised, controlled, blinded-endpoint study. We will enrol 80 patients with CH who are not responding to medication. The enrolled patients will be randomly divided into two groups: the nerve block (NB) group and the PRF group. All patients will undergo CT-guided pterygopalatine ganglion puncture. A mixture containing steroids and local anaesthetics will be slowly injected into the patients in the NB group. The patients in the PRF group will be treated with PRF at 42°C for 360 s. After treatment, the duration of cluster periods; degree of pain during headache attacks; frequency of headache attacks; duration of each headache attack; dose of auxiliary analgesic drugs; duration of remission; degree of patient satisfaction; effectiveness rates at 1 day, 3 days, 1 week, 2 weeks, 1 month, 3 months, 6 months, and 1 year after the procedure; and intraoperative and postoperative adverse events will be compared between the two groups.Ethics and disseminationThis study was approved by the institutional ethics committee of the Beijing Tiantan Hospital (approval number: KY 2018-027-02). The results of the study will be published in peer-reviewed journals, and the findings will be presented at scientific meetings.Trial registration numberNCT03567590; Pre-results.


2011 ◽  
Vol 42 (01) ◽  
Author(s):  
S. Nägel ◽  
D. Holle ◽  
N. Desmarattes ◽  
N. Theysohn ◽  
C. Gaul ◽  
...  

2020 ◽  
Vol 132 (3) ◽  
pp. 717-720 ◽  
Author(s):  
Sérgio A. F. Dantas ◽  
Eduardo J. L. Alho ◽  
Juliano J. da Silva ◽  
Nilson N. Mendes Neto ◽  
Erich Talamoni Fonoff ◽  
...  

Hypothalamic deep brain stimulation (DBS) has been used for more than a decade to treat cluster headache (CH) but its mechanisms remain poorly understood. The authors have successfully treated a patient with CH using hypothalamic DBS and found that the contact used for chronic stimulation was located in a white matter region posterior to the mammillary bodies. Fiber tracts crossing that region were the medial forebrain bundle and those interconnecting the hypothalamus and brainstem, including the dorsal longitudinal fasciculus. Because the stimulation of axons is an important mechanism of DBS, some of its clinical effects in CH may be related to the stimulation of fibers interconnecting the hypothalamus and brainstem.


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