Deep brain stimulation in headache

Research output: Contribution to journalReview articlepeer-review

Abstract

Background: Deep brain stimulation of the posterior hypothalamic area was first introduced in 2000 to treat drug-refractory chronic cluster headache (CH). Findings: So far, hypothalamic stimulation has been employed in 79 patients suffering from various forms of intractable short-lasting unilateral headache forms, mainly trigeminal autonomic cephalalgias. The majority were (88.6%) chronic CH, including one patient who suffered from symptomatic chronic CH-like attacks; the remaining were short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT), one had paroxysmal hemicranias and one symptomatic trigeminal neuralgia. Overall, after a mean follow up of 2.2 years, 69.6% (55) hypothalamic-stimulated patients showed a ≥50% improvement. Conclusions: These observations need confirmation in randomised, controlled trials. A key role of the posterior hypothalamic area in the pathophysiology of unilateral short-lasting headaches, possibly by regulating the duration rather than triggering the attacks, can be hypothesised. Because of its invasiveness, hypothalamic stimulation can be proposed only after other, less-invasive, neurostimulation procedures have been tried.

Original languageEnglish
Pages (from-to)1143-1148
Number of pages6
JournalCephalalgia
Volume36
Issue number12
DOIs
Publication statusPublished - Oct 1 2016

Keywords

  • cluster headache
  • Deep brain stimulation
  • drug resistant
  • hypothalamic stimulation
  • intractable
  • neurostimulation
  • paroxysmal hemicrania
  • SUNCT
  • trigeminal autonomic cephalalgias
  • trigeminal neuralgia

ASJC Scopus subject areas

  • Clinical Neurology

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