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 language | English |
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Pages (from-to) | 1143-1148 |
Number of pages | 6 |
Journal | Cephalalgia |
Volume | 36 |
Issue number | 12 |
DOIs | |
Publication status | Published - 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