Skip Navigation LinksHome > June 2009 - Volume 22 - Issue 3 > Neurostimulation approaches to primary headache disorders
Current Opinion in Neurology:
doi: 10.1097/WCO.0b013e32832ae61e
Headache: Edited by Peter Goadsby

Neurostimulation approaches to primary headache disorders

Bartsch, Thorstena; Paemeleire, Koenb; Goadsby, Peter Jc

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Abstract

Purpose of review: Conventional management options in medically intractable chronic-headache syndromes, such as chronic migraine, chronic cluster headache and hemicrania continua, are often limited. This review summarizes the current concepts, approaches and outcome data of invasive device-based neurostimulation approaches using occipital-nerve stimulation and deep-brain stimulation.

Recent findings: Recently, there has been considerable progress in neurostimulation approaches to medically intractable chronic-headache syndromes. Previous studies have analysed the safety and efficacy of suboccipital neurostimulation in drug-resistant chronic-headache syndromes such as in chronic migraine, chronic cluster headache and hemicrania continua. The studies suggest suboccipital neurostimulation can have an effect even decades after onset of headaches, thus representing a possible therapeutic option in patients that do not respond to any medication. Similarly, to date over 50 patients with cluster headaches underwent hypothalamic deep-brain stimulation. From these, an average of 50–70% did show a significant positive response.

Summary: These findings will help to further elucidate the clinical potential of neurostimulation in chronic headache.

© 2009 Lippincott Williams & Wilkins, Inc.

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