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Occipital Nerve Stimulation for Pain Modulation in Drug-Resistant Chronic Cluster Headache

Occipital nerve stimulation (ONS) is a surgical treatment proposed for drug-resistant chronic cluster headache (drCCH). Long-term series assessing its efficacy are scarce. We designed a retrospective observational study with consecutive sampling, evaluating the follow-up of 17 drCCH patients who und...

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Autores principales: Díaz-de-Terán, Javier, Membrilla, Javier A., Paz-Solís, José, de Lorenzo, Iñigo, Roa, Javier, Lara-Lara, Manuel, Gil-Martínez, Alfonso, Díez-Tejedor, Exuperio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7918621/
https://www.ncbi.nlm.nih.gov/pubmed/33668570
http://dx.doi.org/10.3390/brainsci11020236
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author Díaz-de-Terán, Javier
Membrilla, Javier A.
Paz-Solís, José
de Lorenzo, Iñigo
Roa, Javier
Lara-Lara, Manuel
Gil-Martínez, Alfonso
Díez-Tejedor, Exuperio
author_facet Díaz-de-Terán, Javier
Membrilla, Javier A.
Paz-Solís, José
de Lorenzo, Iñigo
Roa, Javier
Lara-Lara, Manuel
Gil-Martínez, Alfonso
Díez-Tejedor, Exuperio
author_sort Díaz-de-Terán, Javier
collection PubMed
description Occipital nerve stimulation (ONS) is a surgical treatment proposed for drug-resistant chronic cluster headache (drCCH). Long-term series assessing its efficacy are scarce. We designed a retrospective observational study with consecutive sampling, evaluating the follow-up of 17 drCCH patients who underwent ONS. Our main endpoint was the reduction the rate of attacks per week. We also evaluated the pain intensity through the Visual Analogue Scale (VAS), patient overall perceived improvement and decrease in oral medication intake. After a median follow-up of 6.0 years (4.5–9.0), patients decreased from a median of 30 weekly attacks to 22.5 (5.6–37.5, p = 0.012), 7.5 at 1 year (p = 0.006) and 15.0 at the end of follow-up (p = 0.041). The VAS decreased from a median of 10.0 to 8.0 (p = 0.011) at three months, to 7.0 (p = 0.008) at twelve months and 7.0 (p = 0.003) at the end of the follow-up. A total of 23.5% had an overall perceived improvement of ≥70% at 3 months, 41.2% at 1 year and 27.8% at the end of follow-up. Reducing prophylactic oral medication was possible in 76.5% and it was stopped in 17.7%. Triptan use decreased in all the responder patients and 17.7% stopped its intake. A total of 41.2% presented mild adverse events. In conclusion, our long-term experience suggests that ONS could be an interesting option for drCCH-selected patients, as it is a beneficial and minimally invasive procedure with no serious adverse events.
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spelling pubmed-79186212021-03-02 Occipital Nerve Stimulation for Pain Modulation in Drug-Resistant Chronic Cluster Headache Díaz-de-Terán, Javier Membrilla, Javier A. Paz-Solís, José de Lorenzo, Iñigo Roa, Javier Lara-Lara, Manuel Gil-Martínez, Alfonso Díez-Tejedor, Exuperio Brain Sci Article Occipital nerve stimulation (ONS) is a surgical treatment proposed for drug-resistant chronic cluster headache (drCCH). Long-term series assessing its efficacy are scarce. We designed a retrospective observational study with consecutive sampling, evaluating the follow-up of 17 drCCH patients who underwent ONS. Our main endpoint was the reduction the rate of attacks per week. We also evaluated the pain intensity through the Visual Analogue Scale (VAS), patient overall perceived improvement and decrease in oral medication intake. After a median follow-up of 6.0 years (4.5–9.0), patients decreased from a median of 30 weekly attacks to 22.5 (5.6–37.5, p = 0.012), 7.5 at 1 year (p = 0.006) and 15.0 at the end of follow-up (p = 0.041). The VAS decreased from a median of 10.0 to 8.0 (p = 0.011) at three months, to 7.0 (p = 0.008) at twelve months and 7.0 (p = 0.003) at the end of the follow-up. A total of 23.5% had an overall perceived improvement of ≥70% at 3 months, 41.2% at 1 year and 27.8% at the end of follow-up. Reducing prophylactic oral medication was possible in 76.5% and it was stopped in 17.7%. Triptan use decreased in all the responder patients and 17.7% stopped its intake. A total of 41.2% presented mild adverse events. In conclusion, our long-term experience suggests that ONS could be an interesting option for drCCH-selected patients, as it is a beneficial and minimally invasive procedure with no serious adverse events. MDPI 2021-02-13 /pmc/articles/PMC7918621/ /pubmed/33668570 http://dx.doi.org/10.3390/brainsci11020236 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Díaz-de-Terán, Javier
Membrilla, Javier A.
Paz-Solís, José
de Lorenzo, Iñigo
Roa, Javier
Lara-Lara, Manuel
Gil-Martínez, Alfonso
Díez-Tejedor, Exuperio
Occipital Nerve Stimulation for Pain Modulation in Drug-Resistant Chronic Cluster Headache
title Occipital Nerve Stimulation for Pain Modulation in Drug-Resistant Chronic Cluster Headache
title_full Occipital Nerve Stimulation for Pain Modulation in Drug-Resistant Chronic Cluster Headache
title_fullStr Occipital Nerve Stimulation for Pain Modulation in Drug-Resistant Chronic Cluster Headache
title_full_unstemmed Occipital Nerve Stimulation for Pain Modulation in Drug-Resistant Chronic Cluster Headache
title_short Occipital Nerve Stimulation for Pain Modulation in Drug-Resistant Chronic Cluster Headache
title_sort occipital nerve stimulation for pain modulation in drug-resistant chronic cluster headache
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7918621/
https://www.ncbi.nlm.nih.gov/pubmed/33668570
http://dx.doi.org/10.3390/brainsci11020236
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